The combined effect of Levofloxacin and Azithromycin against multidrug-resistant Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa.

Abstract

Pneumonia affects everyone, particularly young children under the age of five. Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeruginosa are one of the main causes of pneumonia as they cause a wide range of diseases which includes lung infections (pneumonia), bloodstream infections, wound or urinary tract infections. A. baumannii has become a major public health threat because 63 percent of Acinetobacter strains are multidrug-resistant. The purpose of this study is to develop a viable method for battling infections brought about by multidrug-resistant Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeruginosa in Bangladesh. From gathered bacterial samples, 10 out of 18 samples were multiple antibiotic resistant which was identified by performing an antibiogram utilizing 18 different antibiotics from 13 of various classes including Macrolides, Polymyxins, Tetracycline, Nitroimidazole, Cephalosporin, Beta-lactam, Quinolone, Fluoroquinolones, Aminoglycosides, and Penicillin. Then, primary screening of antibiotic susceptibility was done which categorized the pathogens into multidrug-resistant, extensively drug-resistant (XDR), and pan-drug-resistant (PDR). Next, by using the Minimum Inhibitory Concentration (MIC) method, individual antibiotics and a combination of screened antibiotics activity were measured. Afterward, the Fractional Inhibitory Concentration (FIC) index to provide statistical substantiation of results. The highest demonstrated MIC value for Levofloxacin was 400 μg/ml, while the lowest was 50 μg/ml. The highest value for Azithromycin was 400 μg/ml and the lowest was 100 μg/ml. For Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeruginosa samples, a synergic effect was found in Levofloxacin in combination with azithromycin determined by FIC Index was below 0.5 suggesting the synergistic effect of their combination. The research result is very significant because by using a combination of antibiotics, the needed amount of antibiotics on resistant pathogens can be decreased. This study has far-reaching consequences for the future of combination therapy against multidrug-resistant bacteria.