Activity of Aspirin Alone and in Combination with Cefixime Against Clinical Isolates of Streptococcus pyogenes In Vitro, a Pilot Study

Abstract

Pharyngitis can be caused by Streptococcus pyogenes; this pathogen also has been associated
with invasive infection as sepsis and fulminate systemic infections . It is imperative cause for fatal condition
in children like acute rheumatic fever and rheumaic heart disease. Development of strains that resistant to
antibiotics makes such disease a dangerous clinical challenge particularly in children, so in order to overcoming this resistance, a nonsteroidal anti-inflammatory drugs (NSAID) is repurposed as antimicrobials
against this microorganisms to be combined with the anti-microbial suggested by WHO rule of care. The
aim was to evaluate the antimicrobial activity of aspirin and an aspirin-cefixime combination against multidrug-resistant S. pyogenes isolated from clinical cases of pharyngitis. A multidrug-resistant strain of S.
pyogenes was isolated from patients had pharyngitis. It was cultivated for determination of MIC for aspirin-cefixime combination in relationship with each drug alone and to determine combination index. A
significant synergism was found between aspirin-cefixime (combination index ˂ 1) p = 0.009 and Z score =
2.5 further confirmation of MIC had assessed by two folds of dilutions to achieve reasonable evidence. There
was a significant synergistic effect achieved from combining aspirin with cefixime against S. pyogenes isolate
in culture.We recommended further evaluation for the antistreptococcal effect of the combined aspirin-cefixime on more dilutions of MIC assay and to investigate data of this combination clinically in patients with
S. pyogenes pharyngitis.