The intrinsic antimicrobial activity of selected sclerosing agents in sclerotherapy.

Background: Detergent sclerosing agents may have intrinsic antimicrobial properties. In addition, they may have synergistic effects with other antibiotics such as penicillin. They may induce suppression of intrinsic resistance to penicillin in Staphylococcus aureus.

Objective: It is in this setting that the present study was carried out in order to determine the degree of suppression of resistance to methicillin and oxacillin in S. aureus by two detergent sclerosing solutions.

Methods: Four strains of S. aureus including a quality control strain were isolated. The minimal inhibitory concentration (MIC) of Sotradecol 1.0% and Polidocanol 0.5% were determined in Mueller Hinton Broth. These dilutions were subsequently seeded with 10(5) organisms of the strain of S. aureus being tested. Serial dilutions of penicillin were made and then the sclerosing agents were added in the appropriate dilutions.

Results: Sotradecol 1.0% produced a MIC of 1/64 in two strains of S. aureus and 1/128 in two other variant strains. Polidocanol 0.5% produced a MIC of 1/64 against two strains of S. aureus and an MIC of 1/8 and 1/4 with two other variant strains. In addition, in three of the four S. aureus strains both sclerosing agents had synergistic activity with penicillin and augmented its activity approximately 16-fold.

Conclusion: This study presents the first successful modification in which detergent sclerosing solutions influence methicillin resistance in a Staphylococcal species. This points out a new potential therapeutic indication for this class of agents.