High resistance of Pseudomonas aeruginosa to paromomycin, an agent used for selective bowel decontamination (SBD)

Abstract

[english] Background: Paromomycin is used for selective bowel decontamination (SBD) in patients undergoing bone marrow transplantation in many hospitals, but there are no published resistance data for this compound in the recent medical literature. The aim of this study was to investigate the in vitro activity of paromomycin against the common intestinal bacteria and .Methods: 94 isolates and 77 isolates derived from clinical specimens were tested by broth microdilution against paromomycin and amikacin, respectively, following the CLSI recommendations for testing amikacin.Results: 86 of 94 isolates (91%) and 71 of 77 isolates (92%) showed in vitro susceptibility to amikacin (MIC90 for both compounds: 16 µg/ml, range: 1–32 µg/ml for and for). Paromomycin was active against 83/94 isolates (88%; MIC90: 32 µg/ml, range: 2–>128 µg/ml), but showed poor in vitro activity against (3/77 isolates susceptible [4%]; MIC90: >128 µg/ml, range: 2–>128 µg/ml).Conclusion: If SBD with inclusion of an aminoglycoside antibiotic is applied, paromomycin should not be used unless local resistance data provide evidence of a sufficient in vitro activity of this compound against .

Keywords

• paromomycin
• P. aeruginosa
• E. coli
• minimal inhibitory concentration (MIC)
• selective bowel decontamination (SBD)