Effect of Vancomycin and Teicoplanin Alone or in Combination with Fusidic Acid or Amikacin against Methicillin-Resistant Staphylococci

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Abstract
The action of two glycopeptides (vancomycin and teicoplanin) alone or in combination with amikacin or fusidic acid has been studied against 10 non-repetitive strains of methicillin-resistant Staphylococcus. The plotted killing curves show that the combination of vancomycin or teicoplanin plus fusidic acid always exhibited an antagonist effect at 24 h for the 10 strains. The combination vancomycin or teicoplanin plus amikacin shows the same effect at 24 h as vancomycin or teicoplanin alone. Thus, the combination glycopeptide plus amikacin does not alter the activity of the glycopeptide but does increase the spectrum of activity of the combination versus Gram-negative nosocomial bacteria (Pseudomonas aeruginosa, Acinetobacter sp). The vancomycin or teicoplanin plus fusidic acid combination may be responsible for bacteriological failure against methicillin-resistant Staphylococcus.