Question of the Week

Question :
Posted On : 07 Mar 2018
Is Ceftriaxone and sulbactam combination rational_? Because half life of sulbactam is very much less when compared to ceftriaxone. but many companies are coming up with this combination and promoting its use, particularly for serious infections including enteric fever.
Expert Answer :
Sulbactam irreversibly inhibits the hydrolytic activity of beta-lactamases. In combination with antibiotics, the activity of the partner antibiotic against beta-lactamase-producing bacteria is restored. One of the particular advantages of using sulbactam-containing combinations is that sulbactam itself has inherent activity against some Acinetobacter baumannii. Sulbactam combinations have not demonstrated strong selective pressures for extended-spectrum beta-lactamase-producing Enterobacteriaceae and vancomycin-resistant enterococci. Study in Antimicrobial Agents and Chemotherapy has found that the enhanced activity of Ceftriaxone observed in the presence of an inhibitor of P-lactamase, sulbactam, in vitro and in an endocarditis model seems promising for the treatment of serious infections due to members of the Enterobacteriaceae producing an extended-spectrum ,-lactamase such as SHV-2. {1990: pg 581}
Answer Discussion :
Pratik Babel
It will be of no use if half life of sulbactam is significantly less than ceftriaxone
3 years ago
Omaima Mehmood
In our part of the world (pakistan)we are facing extensive drug resistance XDR of conventional abx to enteric fever. So blood c/s is required and organisms are responding to meronem, impenem and Azithromycin only as per the study. .00105-18.
3 years ago
Yes,it is.use in beta lactamase cases.
3 years ago

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