Minimum Inhibitory Concentration and Postantibiotic Effect of Amikacin for Equine Isolates of Methicillin‐Resistant Staphylococcus aureus In Vitro

Abstract

To report the minimum inhibitory concentration (MIC) of amikacin sulfate for equine clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) and characterize the initial kill and duration of the postantibiotic effect (PAE) for selected strains. Experimental study. Isolates of MRSA (n=35) had their amikacin MIC determined using the E-test agar diffusion method. Two isolates with MICs>256 microg/mL limit were further characterized using broth macrodilution. Six distinct isolates with amikacin MICs of 32, 48, 128 (2 isolates) and 500 (2 isolates) microg/mL had PAE determinations made over a range of amikacin concentrations from 31.25-1000 microg/mL using standard culture-based techniques. Median MIC of the 35 isolates was 32 microg/mL (range 2 to >256 microg/mL). Mean PAE of selected MRSA strains had an overall mean (all amikacin doses) of 3.43 hours (range 0.10-9.57 hours). PAE for MRSA exposed to amikacin at 1000 microg/mL was 6.18 hours (range 3.30-9.57 hours), significantly longer than that for all other concentrations (P<.0001). There was no statistically significant effect of isolate MIC on PAE. Isolates had a wide range of MIC; however, growth of all 6 selected strains were inhibited within the range of concentrations tested, including 2 strains with MICs of 500 microg/mL. PAE duration was not influenced by the MIC of amikacin but was significantly longer with treatment at 1000 microg/mL than at lower concentrations. Clinical isolates of MRSA are susceptible to amikacin at concentrations achieved by regional perfusion: however, the modest duration of PAE observed suggest that further laboratory and in vivo evaluation be conducted before recommending the technique for clinical use.