{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T05:53:14Z","timestamp":1784613194499,"version":"3.55.0"},"reference-count":17,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Chemotherapy"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Introduction:<\/i><\/b> Community-acquired urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing <i>Escherichia coli<\/i> have limited oral therapeutic options and pose significant clinical challenges. The goal of this study was to evaluate the in vitro synergy between CFM and AMC against ESBL <i>E. coli<\/i> with aims to identify an oral treatment option for UTIs. <b><i>Methods:<\/i><\/b> Minimum inhibitory concentrations (MICs) of CFM in the presence of AMC were determined for 46 clinical isolates by placing a CFM Etest on a plate with AMC impregnated in the agar. Isolates with CFM MIC \u22641 \u03bcg\/mL in the presence of AMC were considered susceptible to the CFM and AMC combination. Five isolates were then selected for further testing using time-kill analysis in the presence of CFM, AMC, and CFM with AMC. Time-kill curves were plotted to determine synergy over 24 h. <b><i>Results:<\/i><\/b> AMC improved the activity of CFM against ESBL <i>E. coli<\/i> isolates by 128-fold in the Etest analysis with 85% of tested isolates being susceptible to the combination. A fourfold or greater reduction in CFM MIC was exhibited in 44 of 46 (96%) isolates when in the presence of AMC. Synergy and bactericidal activity between CFM and AMC were exhibited in each of the five isolates tested by time-kill analysis. <b><i>Discussion\/Conclusion:<\/i><\/b> This study found that AMC improves the activity of CFM against ESBL <i>E. coli<\/i> and that this antibiotic combination has potential as an oral therapeutic option to treat ESBL <i>E. coli<\/i> UTIs. <\/jats:p>","DOI":"10.1159\/000524707","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T21:02:13Z","timestamp":1651525333000},"page":"261-268","source":"Crossref","is-referenced-by-count":4,"title":["Examining the Combination of Cefixime and Amoxicillin\/Clavulanate against Extended-Spectrum Beta-Lactamase-Producing <b><i>Escherichia coli<\/i><\/b> Isolates"],"prefix":"10.1159","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8357-2255","authenticated-orcid":false,"given":"Haedi","family":"Thelen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Dilworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9e-Claude","family":"Mercier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01519-08"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa183"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06248-11"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00526-12"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2007.01858.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00145-19"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp498"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200012001-00002"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199528050-00003"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.5812\/jjm.13792"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2010.190"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlab019"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlab020"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro3432"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2016.04.022"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2019.0065"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz824"}],"container-title":["Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/524707","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/524707","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T14:56:06Z","timestamp":1745420166000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000524707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,11,23]]},"published-print":{"date-parts":[[2022,11,29]]}},"URL":"https:\/\/doi.org\/10.1159\/000524707","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.19690819","asserted-by":"subject"}]},"ISSN":["0009-3157","1421-9794"],"issn-type":[{"value":"0009-3157","type":"print"},{"value":"1421-9794","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]}}}