Susceptibility of 497 Clinical Isolates of Gram-Negative Anaerobes to Trovafloxacin and Eight Other Antibiotics

Abstract

Trovafloxacin is a novel investigational trifluoronaphthyridone antibiotic with broad-spectrum activity against Gram-positive and Gram-negative organisms. Its in-vitro activity and those of eight other antimicrobial agents were evaluated against 497 clinical isolates of Gram-negative anaerobic bacteria by the agar dilution method. Trovafloxacin had excellent activity, with a minimum inhibitory concentration (MIC) range of <0.03-4 μg/ml, against all species. Out of the 497 isolates tested, 496 (99.5%) were inhibited by a concentration of ≤2.0 μg/ml of trovafloxacin; the remaining two strains were inhibited by a concentration of 4.0 μg/ml. The MIC50s and MIC90s were 0.12 μg/ml and 1.0 μg/ml, respectively. Meropenem, imipenem and piperacillin/tazobactam were also very active. Overall, at the MIC90s, trovafloxacin was as active as meropenem, slightly more active than metronidazole and imipenem, twice as active as amoxicillin-clavulanic acid, five times more active than piperacillintazobactam and 68 times more active than clindamycin. About 21% of the isolates were resistant to cefoxitin, 30% to clindamycin and 40% to piperacillin. Five species in the Bacteroides fragilis group of isolates were highly resistant to metronidazole (MIC >128 μg/ml). In general, the relatively more resistant species were the B. vulgatus, B. ovatus, B. thetaiotaomicron, and B. fragilis sensu stricto, in that order. All the isolates of the B. fragilis group and about 50% of the Prevotella spp. were β-lactamase positive. Trovafloxacin certainly holds promise as an alternative drug for therapy of anaerobic infections.