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Forschungsdatenbank PMU-SQQUID

Combinations of cefoxitin plus other β-lactams are synergistic in vitro against community associated methicillin-resistant Staphylococcus aureus.
Banerjee, R; Fernandez, MG; Enthaler, N; Graml, C; Greenwood-Quaintance, KE; Patel, R;
Eur J Clin Microbiol Infect Dis. 2013; 32(6):827-833
Originalarbeiten (Zeitschrift)


Fernandez Martha Georgina
Freundlinger Nina


In vitro studies demonstrate that oxacillin minimal inhibitory concentrations (MICs) of methicillin-resistant S. aureus (MRSA) strains USA300 and 400 decrease in the presence of cefoxitin. The aim of this study was to characterize the activity of cefoxitin plus β-lactams against a collection of MRSA isolates. We assessed the in vitro antimicrobial activity of a selection of β-lactams alone and together with subinhibitory concentrations of cefoxitin against a collection of MRSA, methicillin-susceptible S. aureus (MSSA), and vancomycin-intermediate S. aureus (VISA) isolates using MICs and time kill assays. For community-associated (CA) MRSA strains USA300 and USA400, MICs of nafcillin, cefazolin, cephalexin, cefuroxime, ceftriaxone and cefotaxime decreased by 8- to 64-times in the presence of 10 μg/ml cefoxitin. In contrast, for hospital-associated (HA) strains COLn, N315, and Mu50, there was no change in any β-lactam MIC in the presence of cefoxitin. When combined with cefoxitin, the cephalexin MIC decreased for eight CA-MRSA and five MSSA sequence types but did not change for seven HA-MRSA sequence types. β-lactam/cefoxitin combinations were synergistic against CA- but not HA-MRSA strains in time kill assays. Cefoxitin combined with a variety of β-lactams enhances their activity against CA-MRSA strains in vitro. Further studies of combination β-lactam therapy may provide insight into β-lactam biology, penicillin binding protein cooperativity, and novel therapeutic strategies against MRSA.

Useful keywords (using NLM MeSH Indexing)


Community-Acquired Infections

Cross Infection

Drug Synergism


Methicillin-Resistant Staphylococcus aureus/drug effects*

Methicillin-Resistant Staphylococcus aureus/isolation*


Microbial Sensitivity Tests

Staphylococcal Infections/microbiology*