Studying synergy of antibacterial drugs using the “checkerboard” method and the “time-kill” analysis

Abstract

The use of combinations of antibiotics is a promising area of antibiotic therapy of bacterial infections caused by antibiotic-resistant strains. The main goal of combined antibiotic therapy is to achieve a synergistic effect and to expand a spectrum of antibacterial activity against multi-resistant microorganisms. Due to the presence of various mechanisms of resistance in bacteria, even to drugs of the same group, the microbiological efficacy of antibiotic combinations is difficult to predict. Therefore, to select effective combinations of antibiotics, it is required to conduct a microbiological testing of isolates isolated from a particular patient. Currently, in the Republic of Belarus, the appointment of combined antibiotic therapy is carried out empirically, and in the event of its clinical ineffectiveness, the drugs are replaced. One of the reasons for a limited testing, with the availability of culture media and diagnostic materials, is the lack of regulatory and technical methods for identifying synergy adapted to local microbiological laboratories. The purpose of this publication was to analyze the literature data illustrating the relevance of analyzing the methods for studying the effects of synergy of antibacterial drugs and the possibility of their introduction into practical medicine. As a result of a search for publications in the PubMed database on the topic of increasing the antibacterial effect of antibiotics on the request the “checkerboard” method and the “time-kill” analysis for the period from 2016 to 2021, 947 results were found with an upward trend in research. “Checkerboard” and “time-kill” assays are the most common, reliable in vitro tests that reflect the effects of antibiotic combinations and the effects of antibiotic combinations with other compounds.