Effect of proton pump inhibitors on in vitro activity of tigecycline against several common clinical pathogens

Wentao Ni; Xuejiu Cai; Beibei Liang; Yun Cai; Junchang Cui; Rui Wang

doi:10.1371/journal.pone.0086715

Effect of proton pump inhibitors on in vitro activity of tigecycline against several common clinical pathogens

PLoS One. 2014 Jan 21;9(1):e86715. doi: 10.1371/journal.pone.0086715. eCollection 2014.

Authors

Wentao Ni¹, Xuejiu Cai¹, Beibei Liang², Yun Cai², Junchang Cui¹, Rui Wang²

Affiliations

¹ Department of Respiratory Diseases, Chinese People's Liberation Army General Hospital, Beijing, China.
² Department of Clinical Pharmacology, Chinese People's Liberation Army General Hospital, Beijing, China.

Abstract

In this study, we evaluated the effect of proton pump inhibitors (PPIs) on in vitro antimicrobial activity of tigecycline against several species of clinical pathogens. Clinical non-duplicate isolates of Acinetobacter baumannii, Staphylococcus aureus, Enterococcus faecalis and three species of Enterobacteriaceae (Escherichia coli, Klebsiella pneumonia and Enterobacter cloacae) were collected from a tertiary hospital and their MICs of tigecycline alone and in combination with PPIs (omeprazole, lansoprazole and pantoprazole) were determined. With one randomly selected isolate of each bacterial species, an in vitro time-kill study was performed for the confirmation of the effect of PPIs on tigecycline activity. The MIC changes after PPIs addition correlated with the PPIs concentrations in the test media. Compared with tigecycline alone, the addition of 5 mg/L PPIs could increase the MICs of tigecycline by 0 to 2-fold and the addition of 50 mg/L PPIs could increase the MICs of tigecycline by 4 to >128-fold. The time-kill study confirmed that the addition of PPIs could affect the in vitro activity of tigecycline. Even at low concentration (5 mg/L) of omeprazole and pantoprazole, antagonistic effect could be observed in E. cloacae and E. faecalis strains. We conclude that In vitro activity of tigecycline can be influenced by the presence of PPIs in a concentration-dependent manner.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Infective Agents / pharmacology*
Bacteria / drug effects*
Bacteria / metabolism*
Microbial Sensitivity Tests / methods
Minocycline / analogs & derivatives*
Minocycline / metabolism
Proton Pump Inhibitors / pharmacology*
Tigecycline

Substances

Anti-Infective Agents
Proton Pump Inhibitors
Tigecycline
Minocycline

Grants and funding

This work was supported by the National Natural Science Foundation of China (no. 81371855) and the Beijing Municipal Natural Science Foundation of China (no. 7112127). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.