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Combined effect of Cefixime and Azithromycin against multiple antibiotics

resistant Klebsiella pneumoniae and Pseudomonas aeruginosa

Conference Paper · December 2020

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5 authors, including:

Fariba Salahuddin Shaeri Nawar

BRAC University BRAC University
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Maliha Tabassum Rashid Akash Ahmed

BRAC University BRAC University
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 Combined effect of Cefixime and Azithromycin against multiple antibiotics resistant Klebsiella
pneumoniae and Pseudomonas aeruginosa

Fariba Salahuddin1 , Shaeri Nawar2, Maliha Tabassum Rashid 3, Akash Ahmed 4 , M. Mahboob Hossain 5*

1,2,3
Student, Biotechnology Program, Brac University, Bangladesh
4
Lecturer, Microbiology Program, Brac University, Bangladesh
5
Professor, Microbiology Program, Brac University, Bangladesh
*Corresponding Author’s E-mail: mmhossain@bracu.ac.bd

Introduction:
One of the prime pathogens of pneumonia is Klebsiella pneumoniae. It seems pretty uncomplicated to treat K.
pneumoniae, however, it is very challenging to combat because of antimicrobial resistance. The purpose of the
study was development of a new approach to treat antibiotic-resistant K. pneumoniae infection.

Methods:
K. pneumoniae and P. aeruginosa samples were collected in slanted nutrient agar. A total of 30 bacterial samples
were studied against 10 antibiotics. After the primary screening, 4 isolates were XDR and 4 were PDR.
Combination of cefixime with other antibiotics (cefixime + azithromycin, cefixime + tetracycline, cefixime +
chloramphenicol, cefixime + levofloxacin) was done and cefixime + azithromycin antibiotic solution showed
synergistic effect. Furthermore, the minimum inhibitory concentration (MIC) was performed for the cefixime +
azithromycin combination followed by the determination of fractional inhibitory concentration (FIC) value, a
statistical tool to determine the effect of the combination cefixime and azithromycin.

Results:
The combination of cefixime + azithromycin showed better result in terms of inhibiting the growth of K.
pneumoniae and P. aeruginosa. For Pseudomonas, MDR category, FIC value was 0.354, 0.214,0.773,1.833. For
XDR category FIC was 0.193,1.1,0.428,0.857. For PDR category FIC was 1.371,1.833,0.773,1.142 respectively.
For Klebsiella pneumoniae MDR category, sample 1,2,3,4, cefixime + azithromycin, FIC value was
0.375,1.1,0.428,0.928. For XDR, sample 5,6,7,8, FIC was 0.757,0.5625,0.193,0.458. PDR for sample 9,10,11,12,
FIC is 0.773,0.714,0.833,0. 458. However, the average FIC value for cefixime plus azithromycin for both P.
aeruginosa and K. pneumoniae was found to be >0.5 and < 1.0 means the combination worked better to inhibit
the growth compare to the antibiotics alone.

Conclusion:
This study only reflects the findings of the in vitro synergistic activities of cefixime and azithromycin against
antibiotic-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa. The use of combined antibiotics is a
common hospital procedure for treating severe infections but the guideline of using the combination has not been
well established yet. Since in vivo tests were not done, investigations may vary with in vitro results.

Cite as
Salahuddin F., Nawar S., Rashid MT, Ahmed A., Hossain M. A Study of Prevalence and Pathogenic Activity of
Bacteria In The Air of Dhaka City And Their Antimicrobial Resistance Pattern. [abstract]. In: proceedings of the
34 Annual Conference of the Bangladesh Society of Microbiologist; 2020 December 20; Dhaka Bangladesh.
Abstract Id: EMB05

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