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The in vitro activity of seven anti-staphylococcal antibiotics alone and in combination with four aminoglycoside antibiotics against 35 clinical isolates of Staphylococcus aureus from blood cultures of patients with endocarditis or septicemia was studied. The combination of nafcillin-gentamicin or nafcillin-tobramycin when compared with nafcillin alone killed significantly more S. aureus at 6 h for 33 of 35 isolates. A significant decrease in viable colony-forming units at 24 and 48 h was demonstrated for a smaller number of isolates. Using the agar dilution antibiotic susceptibility test, significant enhancement of activity was demonstrated against almost all isolates when cephalothin, cefazolin, or clindamycin was combined with gentamicin, tobramycin, or kanamycin. The combination of nafcillin or vancomycin with gentamicin, tobramycin, or kanamycin also showed enhanced activity against the majority of isolates. Oxacillin or methicillin when combined with the aminoglycosides showed enhancement of activity against the least number of isolates. Streptomycin was the least effective of the four aminoglycoside antibiotics studied.
Watanakunakorn et al. (1974) studied this question.