The Possible Synergism Effect of Amoxyclav Combined with Gentamicin and Paracetamol against Blood Stream Escherichia coli

Abstract

Abstract Background: Some bacteria have developed resistance to antibiotics that were once commonly used to treat them. Escherichia coli is one of the most common causes of bloodstream bacterial infections. This research was performed to study the effect of some antibiotics on the growth of E. coli by combination with amoxyclav. Materials and Methods: E. coli were isolated from the blood stream of 20 patients and cultured in three media (blood agar, MacConkey agar, and eosin methylene blue agar). The cultures were incubated for 24 h at a temperature of 37°C. The well diffusion method used to evaluate the activity of antimicrobial agents. The antibiotics (paracetamol, gentamicin, and amoxyclav) were added separately in one petri dish and in combination with amoxyclav in another petri dish to evaluate the effect of antibiotics on bacterial growth before and after the addition of amoxyclav. Results: The study showed that males were more infected (65%) than females (35%), without significant differences (P = 0.18). The addition of amoxyclav increased the effect of gentamicin from 28.9 ± 2.7 to 33.7 ± 7.47 mm, showing significant differences (P = 0.013). The addition of paracetamol to amoxyclav showed antagonism, decreasing the effect from 31.75 + 9.41 to 29.95 ± 8.66 mm), without significant differences (P = 0.53). Conclusions: The combination of gentamicin with amoxyclav has a synergistic effect against E. coli clinically isolated from blood streams (P = 0.013). The addition of paracetamol to amoxyclav showed an antagonism effect, but it was still insignificant (P = 0.53).