Comparative In Vitro Activity of Sitafloxacin Against
Bacteria Isolated from Thai Patients with Urinary Tract
Infections and Lower Respiratory Tract Infections in 2016
Surapee Tiengrim MSc*1, Piroon Mootsikapun MD*2, Lumyai Wonglakorn MSc*2, Dhitiwat Changpradub MD*3,
Sudaluck Thunyaharn MSc*3, Woraphot Tantisiriwat MD*4, Somchai Santiwatanakul PhD*4, Aumnat Malithong MD*5,
Nathaporn U-thainual MSc*5, Pattarachai Kiratisin MD*6, Visanu Thamlikitkul MD*6
Affiliation :
*1 Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
*2 Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
*3 Phramongkutklao Hospital, Bangkok, Thailand
*4 Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
*5 Klang Hospital, Bangkok, Thailand
*6 Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine in vitro activity of sitafloxacin compared with other antibiotics against the bacteria isolated from
Thai patients with urinary tract infections and those with lower respiratory tract infections.
Material and Method: One thousand one hundred thirty six clinical isolates of Escherichia coli, Klebsiella pneumoniae,
Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus aureus isolated from different Thai patients with
urinary tract infections or lower respiratory tract infections in 2016 were included. The minimum inhibitory concentrations
(MICs) of sitafloxacin, ciprofloxacin, levofloxacin, amoxicillin-clavulanate, ceftriaxone, ceftazidime, piperacillin-tazobactam,
tigecycline, imipenem, meropenem, and colistin were determined by standard agar dilution method.
Results : The MIC50 and MIC90 values of sitafloxacin against all tested bacteria were lowest when compared with those of
levofloxacin and ciprofloxacin. Sitafloxacin was more active than levofloxacin, ciprofloxacin, amoxicillin-clavulanate,
ceftriaxone, and ceftazidime, but it was less active than piperacillin-tazobactam, tigecycline, imipenem, meropenem, and
colistin against extended-spectrum beta-lactamase (ESBL)-producing E. coli isolates. Sitafloxacin was more active than
levofloxacin, ciprofloxacin, amoxicillin-clavulanate, ceftriaxone, and ceftazidime against ESBL-producing K. pneumoniae.
The activity of sitafloxacin against ESBL-producing K. pneumoniae was comparable to piperacillin-tazobactam, but it was
less active than tigecycline, imipenem, meropenem, and colistin. Sitafloxacin was more active than levofloxacin, ciprofloxacin,
ceftazidime, piperacillin-tazobactam, imipenem, and meropenem, but it was less active than colistin against A. baumannii
isolates. The activity of sitafloxacin against P. aeruginosa isolates was comparable to levofloxacin, ciprofloxacin, ceftazidime,
piperacillin-tazobactam, imipenem, and meropenem, but it was less active than colistin. The in vitro activity of sitafloxacin
against methicillin-resistant S. aureus (MRSA) isolates was more than levofloxacin, but it was less than vancomycin. The
activities of sitafloxacin against tested bacteria isolated from the patients in 2016 were not significantly different from those
isolated in 2010.
Conclusion : Sitafloxacin remains active against the common antibiotic-resistant bacteria causing urinary tract infections
and lower respiratory tract infections in Thai patients isolated in 2016, including ESBL-producing E. coli, ESBL-producing
K. pneumoniae, A. baumannii, P. aeruginosa, and S. aureus, after its use in Thailand for five years.
Keywords : In vitro activity, Sitafloxacin, Fluoroquinolone
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