Comparison of in-vitro Antibiotic Susceptibility of Ciprofloxacin, Cefotaxime, Ceftazidime and Cefepime against Gram Negative Bacilli Infections - A Study from Tertiary Care Centre

Abstract

Introduction: Infections from gram negative bacilli is a challenge for clinicians and laboratory personnel. Treatment of these infections remained as an area of concern. Both fluroquinolones and cephalosporins are most common choice of antibiotics. Despite Cephalosporins, being drug of choice they are expensive also showed many adverse reactions. This study, compares and reevaluates the susceptibility of gram negative bacteria to fluroquinolones (ciprofloxacin) compared to cephalosporins. Method: Various samples(pus, sputum, urine, blood and bodyfluids) were processed according to standard protocols. Antibiotic done susceptibility by using Kirby-baur disc diffusion method. ESBL and Amp C producers were identified using CLSI guidelines. Result: Among 400 isolates, majority were from pus followed by urine, sputum. The most common organism isolated was Klebsiella spp, (33.25%) Escherichia coli (29.5%), Pseudomonas spp (27.25%), Enterobacter spp (6.25%), Citrobacter 5 (1.25%), and Acinetobacter spp (2.5%). Isolates showed 20-80% susceptibility to ciprofloxacin, 30-60% to third and fourth generation cephalosporins. Klebsiella and Pseudomonas showed 64% and 31% susceptibility to ciprofloxacin. Acinetobacter spp showed 30% susceptibility to cefipime and 20% to ciprofloxacin. 34 isolates were ESBL 18 were AmpC producers, of which 15(44%) ESBL and 7(38%) of AmpC producers were ciprofloxacin susceptible. Conclusion: Ciprofloxacin was found to be more effective than the fourth generation cephalosporin (cefepime) against gram negative bacilli. Ciprofloxacin can be considered for treatment as it is more active and cost effective when compared to cephalosporins. Keywords: Fluroquinolones, Cephalosporins, Multidrug resistant, ESBL, Amp C