Rifampicin plus nalidixic acid: a rational combination for the treatment of urinary infection

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Abstract
The combination of rifampicin and nalidixic acid was tested in vitro against a variety of Gram-negative bacilli. Exposure of bacterial cultures to either of these agents alone readily evoked the emergence of resistant bacteria, but when they were used in combination such resistance was mutually suppressed. When tested in conditions simulating those of the exposure of bacteria to drug in the treatment of bacterial cystitis, low concentrations of the combination (10 μg rifampicin plus 2 μg nalidixic acid per ml) suppressed bacterial growth for the whole of the 40 h period of observation, whereas growth occurred within 24 h of first exposure to much higher concentrations (50 μg/ml) of the individual components of the mixture.

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