• Journal of Pharmacopuncture
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• v.25 no.2
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• pp.101-105
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• 2022

Objectives: This study aims to determine the Fractional Inhibitory Concentration Index (FICI) of combinations of Melastoma malabathricum leaf fraction with ciprofloxacin or gentamicin against pathogenic bacteria, Escherichia coli, Staphylococcus aureus, and Bacillus cereus, isolated from Diabetic Foot Ulcer (DFU) patients. Methods: We tested concentrations of 45%, 55%, 65%, and 75% of gentamicin and ciprofloxacin using dilution and agar diffusion methods. The combination of M. malabathricum leaf extract with these antibiotics was tested in vitro against all three bacteria. Results: The combination of M. malabathricum leaf extract and ciprofloxacin gave a FICI value of 0.5, indicating synergistic antibacterial activity against the test bacteria. Conclusion: The results show that the antibacterial effect of a combination of high doses of the leaf extract with either antibiotic is greater than that of the leaf extract and the antibiotics in single use.

• Korean Journal of Pharmacognosy
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• v.31 no.4
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• pp.407-411
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• 2000

Antibacterial activities of magnolol (MGL) and honokiol (HKL) in combination with four representative antibiotics-amoxicillin (AMPC), oxytetracyclin (OTC), gentamicin (GM) and chloramphenicol (CAP)-were evaluated against four bacterial strains. When tested by disk-plate method, five out of eight combinations such as HKL-AMPC, HKL-CAP, MGL- AMPC, MGL-OTC, and MGL-CAP showed additive to synergistic interaction against gram- negative bacterium Salmonella typhimureum. Of these, MGL-AMPC combination turned out to be antagonistic against Sarcina lutea and Bacillus thurungiensis. Against these two grain-positive bacteria, only HKL-GM combination showed additivity to synergism. All the other combinations showed no interactions. Despite these results, however, no synergism was observed in checkerboard titration assay.

• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.45-52
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• 2020

Purpose: This pilot study aimed to evaluate the efficacy of high dose ampicillin-sulbactam and colistin combination therapy for ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) in the pediatric intensive care unit of Pusan National University Children's Hospital. Methods: We retrospectively reviewed 17 pediatric patients with VAP caused by CRAB from June 2017 to August 2018. Ten (58.8%) patients were treated with high dose ampicillin-sulbactam and colistin combination therapy (combination therapy group), whereas 7 were treated with colistin only or with various combinations with or without colistin (other antibiotics group). Clinical and bacteriological outcomes were compared between the groups. Results: The mean duration of fever after antibiotic use was 1.30±1.70 days in the combination therapy group and 1.71±1.49 days in the other antibiotics group. The mean duration of days for negative conversion of endotracheal aspirate bacterial culture after antibiotic therapy was 3.40±1.71 days in the combination therapy group and 11.80±8.86 days in the other antibiotics group. The mortality rate within 30 days of antibiotic therapy was 1/10 (10%) in the combination therapy group and 3/7 (42.9%) in the other antibiotics group. Conclusions: High dose ampicillin-sulbactam and colistin combination therapy as early antibiotic treatment in VAP caused by CRAB in children could improve clinical outcomes.

• Archives of Pharmacal Research
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• v.21 no.1
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• pp.62-66
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• 1998

The resistance inhibitory activities of 54 odorant mixtures (essential oil) from 41 Korean aromatic herbs were tested against multi-drug resistant Staphylococcus aureus SA2, which has resistances to 10 usual antibiotics including chloramphenicol. As results, combinations of 28 kinds of samples from 21 herbs and chloramphenicol have resistance inhibitory activities in dose dependent manner.

• YAKHAK HOEJI
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• v.43 no.6
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• pp.716-728
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• 1999

Whole oil and ketonic fraction (KF) of Leptospermum scoparium have been tested for their antimicrobial activity and combination effect with several antibiotics against various bacterial strains and fungi by using microbiological assay methods. Antibacterial activities of KF against a number of test strains were 2-3 fold stronger than those of whole oil. MICs of the KF were $65~125{\;}{\mu\textrm{g}}/ml$ against seven gram positive bacterial strains, $65~250{\;}{\mu\textrm{g}}/ml$ against 19 methicillin resistance Staphylococcus aureus strains, and $65~50{\;}{\mu\textrm{g}}/ml$ against 14 quinolone resistance strains. However, KF showed little or no activity against gram negative bacteria. MICs of the KF were $16~250{\;}{\mu\textrm{g}}/ml$ against more than 50% of the anaerobic bacterial strains tested. KF showed the higher antibacterial activity than bacitracin against 10 strains of Bacteroids thetaiotaomicron, or three strains of Bacteroides ovatus, and the more active than ciprofloxacin against one strain of Bacteroides thetaiotaomicron and three strains of Bacteroids ovatus. The MICs of KF was 63 and $250{\;}{\mu\textrm{g}}/ml$ against Aspergillus niger and Candida albicans, respectively. Antibacterial activities of KF in combination with 19 antibiotics against 14 strains and with four antifungal agents against one fungal strain were determined by paper strip diffusion method. While most of combination showed additivity, KF showed synergism with bacitracin, exfadroxil, cephradin, and meropenem for 29~57% of the strains tested. However, ofloxacin, enoxacin, sparfloxacin showed antagonism with KF for 43~71% of the strains. KF alone and in combination with bacitracin, gentamycin, neomycin, itraconazole, fluconazole, terfinafine and ketoconazole against five bacterial strains or one fungus strain synergistic effect was demonstrated against 33% of strains examined with FIC index value below 0.5 by checkerboard study. Synergistic effect of KF with gentamicin against Staphylococcus epidermidis 329 (QRS) was found by time-kill study.

• Journal of Microbiology and Biotechnology
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• v.31 no.2
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• pp.189-196
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• 2021

Periplanetasin-2 from cockroach exhibits broad-spectrum antimicrobial activity. The underlying antibacterial mechanisms rely on the stimulation of reactive oxygen species overproduction to induce apoptotic cell death. A promising strategy to increase the bioavailability of periplanetasin-2 involves reducing the dose through combination therapy with other antibacterials that show synergistic effects. Thus, the synergistic antibacterial activity of periplanetasin-2 with conventional antibacterial agents and its mechanisms was examined against Escherichia coli in this study. Among the agents tested, the combinations of periplanetasin-2 with vancomycin and chloramphenicol exhibited synergistic effects. Periplanetasin-2 in combination with vancomycin and chloramphenicol demonstrated antibacterial activity through the intracellular oxidative stress response. The combination with vancomycin resulted in the enhancement of bacterial apoptosis-like death, whereas the combination with chloramphenicol enhanced oxidative stress damage. These synergistic interactions of periplanetasin-2 can help broaden the spectrum of conventional antibiotics. The combination of antimicrobial peptides and conventional antibiotics is proposed as a novel perspective on treatments to combat severe bacterial infection.

• The Journal of the Korean Society for Microbiology
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• v.34 no.6
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• pp.543-554
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• 1999

The purpose of this study was to evaluate the existence of amoxicillin, clarithromycin, and metronidazole resistance Helicobacter pylori and to determine the in-vitro MIC of two and three kinds of antibiotic concominant administration in the isolates. The antimicrobial agents tested against 169 H. pylori included metronidazole, amoxicillin, ciprofloxacin, clarithromycin, omeprazole, josamycin, erythromycin, and tetracycline. MIC of each antimicrobial agents was determined by broth microdilution method. The 169 strains of H. pylori were isolated from biopsy specimens of patients with gastric cancer. $MIC_{50}$ of clarithromycin, amoxicillin, metronidazole, omeprazole, erythromycin, josamycin, tetracycline, and ciprofloxacin was 2.0, 1.0, 4.0, 8.0, 0.5, 0.5, and $0.5\;{\mu}g/ml$, respectively. $MIC_{90}$ of clarithromycin, amoxicillin, metronidazole, omeprazole, erythromycin, josamycin, tetracycline, and ciprofloxacin was 64.0, 64.0, 32.0, 16.0, 8.0, 2.0, and $1.0\;{\mu}g/ml$, respectively. H. pylori isolates were detected in the following resistaince rates: 34.3% to clarithromycin, 31.9% to metronidazole, 20.7% to amoxicillin, 12.4% to erythromycin, and 10.1% to josamycin. The prevalence of the antibiotic resistant strains of H. pylori were detected 18.1% for two kind of antibiotics and 9.6% for three kind of antibiotics, and 3.9% for four kind of antibiotics. The $MIC_{90}$ of clarithromycin-, metronidazole-, and amoxicillin-resistant H. pylori was decreased under the $1\;{\mu}g/ml$ by the two or three kind of antibiotic concomitant administration in-vitro. These results suggest that two or three antibiotics concomitant administration could be more effective for the treatment of clarithromycin-, amoxicillin-, metronidazole-, and josamycin-resistant H. pylori strains.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.283-288
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• 2009

Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia is needed to decide empiric antibiotic treatment. Antibiotics effective against the expected bacterial pathogens should be instituted where necessary. The role of emerging pathogens and the effect of pneumococcal resistance and heptavalent conjugate pneumococcal vaccines are to be considered in practice. There are reports supporting the valid and highly efficacious use of penicillin as a first-line drug for treating CAP. This review raises the issue of the overuse of unnecessary antibiotics in viral CAPs and the use of second or third-line antibiotics for non-complicated pneumonias in most clinical settings.

• The Journal of Internal Korean Medicine
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• v.21 no.4
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• pp.555-563
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• 2000

Objective : In order to know the antibacterial effects of Kyungok-go against Mycobacteria tuberculosis, Methods : In this study, I inverstigated these effects in terms of combination of other antibiotics with and without Kyungok-go on several different media conditions. Results: On Ogawa medium, Kyungok-go of the $10{\mu}/ml$ concentration showed the anti-Mycobacteria tuberculosis activity against antibiotic drug-sensitive strain. On Middle-blue medium, Kyungok-go of the $10{\mu}/ml$ concentration showed the anti-Mycobacteria tuberculosis activity against antibiotic drug-sensitive strain. Kyungok-go showed the anti mycobacteria tuberculosis activity with the meaningful result above a certain concentration. The resistance against M, tuberculosis as the concentration of Kyungok-go was decreased significantlly on the high concentration($500{\mu}/ml$) When rifampicin and Kyungok-go were used together, the resistance was decreased with the statistical significance as to the persistant antibacterial effect against M. tuberculosis, When ciprofloxacin and Kyungok-go were used together, the resistance was decreased with the statistical significance as to the persistant antibacterial effect against M. tuberculosis, The combination of treatment, Kyungok-go with both rifampicin and ciprofloxacin, showed much better antibacterial effect against M, tuberculosis than antibiotics alone. Conclusions : This study shows that Kyungok-go has antibacterial effect against M. tuberculosis and in the combination of treatment, Kyungok-go with antibiotics, showed much better antibacterial effect against M. tuberculosis than antibiotics alone,.

• Journal of Pharmacopuncture
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• v.22 no.1
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• pp.49-54
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• 2019

Objective: Antibiotic resistance is a global health problem and threatens health of societies. These problems have led to a search for alternative approaches such as combination therapy. The aim of the present study was to investigate the effect of caffeine and omeprazole in combination with gentamicin or ciprofloxacin against standard and clinically resistant isolates of Staphylococcus aureus and Escherichia coli. Methods: The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of different agents against bacterial strains were determined. The interaction of non- antibiotic drugs with gentamicin and ciprofloxacin was studied in vitro using a checkerboard method and calculating fraction inhibitory concentration index (FICI). Verapamil as efflux pump inhibitor was used to evaluate the possible mechanism of bacterial resistance to antibiotics. Results: The MIC and MBC values of gentamicin against bacterial strains were in the range of $20-80{\mu}g/ml$ and $40-200{\mu}g/ml$, respectively. Caffeine and omeprazole had no intrinsic inhibitory activity against tested microorganisms. However, upon combination of caffeine with antibiotics, the synergistic effects were observed. Verapamil was able to reduce the MIC values of gentamicin (4 folds) only in some bacterial strains. Conclusion: These findings indicated that caffeine was effective in removing bacterial infection caused by S. aureus and E. coli. The relevant mechanisms of antibiotic resistance were not related to the drug efflux.