Synergistic effect of clinically used antibiotics and peptide antibiotics against Gram-positive and Gram-negative bacteria

Ribosomally synthesized (natural) peptides demonstrate antimicrobial potency and may represent a novel therapeutic approach for the treatment of infections. The aim of the present study was to investigate the interaction between polycationic peptides and clinically used antimicrobial agents in the treatment of clinical isolates of Gram-positive and Gram-negative aerobic bacteria in vitro, using the microbroth dilution method. The combination studies demonstrated synergies between ranalexin and polymyxin E, doxycycline and clarithromycin. Similarly, magainin II was demonstrated to be synergistic with ceftriaxone, amoxicillin clavulanate, ceftazidime, meropenem, piperacillin and β-lactam antibiotics. Buforin II, cecropin P1 and indolicidin were not observed to be synergistic with the clinically used antibiotics, but demonstrated additive effects with them. Notably, no antagonistic effects were identified in all the combinations examined.