URINARY ERADICATION OF METHICILLIN-RESIST ANT STAPHYLOCOCCUS-AUREUS WITH 2 GRAMS AUGMENTIN(R)

Twenty patients with urinary tract infections (13 catheter-related) we re treated orally with 2 g of Augmentin(R) per day Cytobacteriological analysis of urine samples at day 3 of treatment were negative in ever y case. Therapeutic success was confirmed in 14 of the 17 patients who were followed for at least one month. Only one strain was heterogeneo usly resistant to methicillin, and four did not produce betalactamase. The MIC 90 values for amoxycillin and ampicillin were 32 mg/l and the addition in vitro of 400 mg/l of clavulanic acid and 100 mg/l of sulb actam reduced the MICs to less-than-or-equal-to 4 mg/l in respectively 15 and 18 strains. Urinary concentrations of amoxycillin and clavulan ic acid in six patients two hours after ingestion of 1 g of Augmentin( R) varied from one patient to another and were very low at 12 h in som e cases. The behavior of strains belonging to a given antistaphylococc al drug resistance phenotype towards betalactams alone and in combinat ion with betalactamase inhibitors was variable. The isolates involved in the three treatment failures belonged to the group of strains with the highest level of resistance to penicillin A.