In Vitro Synergy of Cefamandole-Tobramycin Combinations

Twenty-five isolates of Staphylococcus aureus, 24 isolates of Escherichia coli, and 25 isolates of Klebsiella pneumoniae obtained from clinical material were tested in vitro for susceptibility to cefamandole, tobramycin and combinations of the two antibiotics utilizing an automated microdilution system. Synergistic or partially synergistic bactericidal effects of the combination were observed against 15 of the S. aureus isolates (60%), 23 of the E. coli isolates (96%), and 19 of the K. pneumoniae isolates (76%) tested. No antagonistic effects of the combination were noted. This study suggests that cefamandole-tobramycin combinations are capable of acting synergistically in vitro against certain gram-positive and gram-negative organisms and may have potential usefulness in clinical situations such as gram-negative rod and staphylococcal sepsis.