Journal of Infection and Public Health
Volume 1, Issue 2 , Pages 105-112, 2008

Unexpected induction of resistant Pseudomonas aeruginosa biofilm to fluoroquinolones by diltiazem: A new perspective of microbiological drug–drug interaction

University of Minnesota, Duluth, College of Pharmacy, Pharmacy Practice and Pharmaceutical Sciences, 1110 Kirby Dr. Life Sciences 232, Duluth, MN 55812, USA

Received 15 August 2008; received in revised form 21 October 2008; accepted 22 October 2008.

Summary 

The increase of multi-drug resistant Pseudomonas aeruginosa infections is a worldwide dilemma. At the heart of the problem is the inability to treat established P. aeruginosa biofilms with standard antibiotic therapy, including fluoroquinolones. We address a previously unstudied question as to the effect of a commonly prescribed calcium channel blocker (CCB) diltiazem on the biofilm growth. Real-time monitoring of the overall growth and killing of P. aeruginosa biofilm during fluoroquinolones therapy in the presence and absence of diltiazem was performed. In this study, we demonstrate that for P. aeruginosa biofilms, resistance to the first-line fluoroquinolones may be induced by the commonly prescribed calcium channel blocker diltiazem.

Keywords: Diltiazem, Pseudomonas aeruginosa, Biofilm, Resistance, Fluoroquinolone

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 This manuscript was presented in part at the Design of Medical Devices conference April 2008, University of Minnesota, Minneapolis, MN. “A High-Throughput Biofilm Model of Treatment Efficacy for Pseudomonas aeruginosa Device Associated Infections”. Acceptance No. 027535.

PII: S1876-0341(08)00030-0

doi:10.1016/j.jiph.2008.10.004

Journal of Infection and Public Health
Volume 1, Issue 2 , Pages 105-112, 2008