Augmentation Effect of Clavulanic Acid with Penicillin, Cephalothin and Ticarcillin against Bacteroides fragilis

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Abstract
The effect of clavulanic acid on the in vitro activity of β-lactam antibiotics against Bacteroides fragilis (154 strains) was tested. The MIC90 on 154 strains of B.fragilis tested was > 64 μg/ml for penicillin and cephalothin, and& > 128 for ticarcillin alone. 32 strains of B.fragilis relatively resistant to the test β-lactam antibiotics (most of them β-lactamase producers) were retested with the addition of clavulanic acid. 90% of the strains were then inhibited by < 8 μg/ml of penicillin and cephalothin, and by 32 jUg/ml of ticarcillin. The strongest β-lactamase producers were the most susceptible, and this was not influenced by change in pH of the diluent for clavulanic acid from 6.0 to 7.4. Both penicillin and cephalothin when combined with clavulanic acid were highly effective against B.fragilis but the therapeutic relevance of these combinations remains to be evaluated.

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