Effect of moxifloxacin versus imipenem/cilastatin treatment on the mortality of mice infected intravenously with different strains of Bacteroides fragilis and Escherichia coli

Schaumann, Reiner; Blatz, R; Beer, J; Ackermann, Grit; Rodloff, Arne C.

doi:10.1093/jac/dkh089

Cited by 11 publications

(12 citation statements)

References 41 publications

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“…In contrast to the moderate activity of moxifloxacin investigated here using the in vitro PK/PD model, moxifloxacin has been shown to be as efficacious as imipenem/cilastatin in the treatment of severe systemic mixed aerobic/anaerobic infection in mice using the same B. fragilis strains and E. coli strain ATCC 25922 (Schaumann et al, 2004). Earlier observations of Onderdonk et al (1976) suggested that E. coli is primarily responsible for the lethal effects in the animals.…”

Section: Resultscontrasting

confidence: 62%

“…The B. fragilis strains and E. coli ATCC 25922 strain were characterized as follows as described previously (Schaumann et al, 2004) The E. coli strains were grown on Endo agar (bioMérieux) and the B. fragilis strains were grown on Columbia agar (Oxoid) supplemented with 5 % sheep blood (Oxoid), vitamin K1 (Sigma) and haemin (Serva Feinbiochemica). After incubation, B. fragilis strains and E. coli strains were harvested from the plates and suspended separately in Brucella broth (Becton Dickinson) supplemented with vitamin K1 and haemin, and incubated overnight at 37 8C under anaerobic and aerobic conditions, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…In a recently published paper investigating serum bactericidal activity of moxifloxacin and gatifloxacin, Stein et al (2003a) reported little or no serum bactericidal activity of either drug if the MICs of gatifloxacin were >2 mg l À1 . However, moxifloxacin was found to be effective in vivo even against a B. fragilis strain with a high MIC level for moxifloxacin in an experimental animal model of severe mixed aerobic/anaerobic infection (Schaumann et al, 2004).…”

Section: Introductionmentioning

confidence: 98%

“…The aim of the present study was to assess the killing activity of moxifloxacin in an in vitro pharmacokinetic/pharmacodynamic (PK/PD) model against four selected B. fragilis strains used previously in the in vivo experimental model (Schaumann et al, 2004). Since anaerobes are often present in mixed infections, kill kinetics were also established for mixed inocula employing the B. fragilis strains together with one of two different Escherichia coli strains, one strain with a low MIC for moxifloxacin and one with a high MIC.…”

Section: Introductionmentioning

confidence: 99%

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Activity of moxifloxacin against Bacteroides fragilis and Escherichia coli in an in vitro pharmacokinetic/pharmacodynamic model employing pure and mixed cultures

Schaumann

Goldstein

Forberg

et al. 2005

Journal of Medical Microbiology

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The objective of this study was to determine the pharmacodynamic (PD) activity of moxifloxacin against four selected Bacteroides fragilis strains (three strains with low MICs and one strain with a high MIC) and two Escherichia coli strains (one strain with a low MIC and one strain with a high MIC) in a pharmacokinetic (PK) in vitro model in pure cultures as well as in mixed cultures. PK/PD assays of moxifloxacin were carried out with an initial maximum concentration of 4 . 0 mg l À1 and a half-life of 13 h. The E. coli strain with the low MIC was rapidly killed in both pure and mixed cultures in the in vitro PK/PD model, while the E. coli strain with the high MIC was not killed. None of the B. fragilis strains were rapidly killed in pure or mixed cultures. The bacterial numbers of the B. fragilis strains with low MICs were reduced by about one to two logs after 12 h in pure cultures. The presence of an E. coli strain with a low or a high MIC in the mixed culture reduced this effect even further.

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Section: Resultscontrasting

confidence: 62%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Activity of moxifloxacin against Bacteroides fragilis and Escherichia coli in an in vitro pharmacokinetic/pharmacodynamic model employing pure and mixed cultures

Schaumann

Goldstein

Forberg

et al. 2005

Journal of Medical Microbiology

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“…Moreover, older isolates may not reflect potential resistance that has since developed from use of the fluoroquinolones. Moxifloxacin has been reported to penetrate and accumulate in the human gastrointestinal mucosa (24) and a comparative mouse model study (19) has supported its use as a single agent in intra-abdominal infections. Clinical studies performed to evaluate the efficacy of moxifloxacin in mixed aerobic/anaerobic intra-abdominal infections have been reported in abstract form (M. Malangoni, J.…”

mentioning

confidence: 98%

In Vitro Activity of Moxifloxacin against 923 Anaerobes Isolated from Human Intra-Abdominal Infections

Goldstein

Citron²,

Warren³

et al. 2006

Antimicrob Agents Chemother

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The in vitro activity of moxifloxacin against 923 recent anaerobic isolates obtained from pretreatment cultures in patients with complicated intra-abdominal infections was studied using the CLSI M11-A-6 agar dilution method. Moxifloxacin was active against 87% (96 of 110) Bacteroides fragilis strains at <1 g/ml and 87% (79 of 90) B. thetaiotaomicron strains at <2 g/ml. Species variation was seen, with B. uniformis, B. vulgatus, Clostridium clostridioforme, and C. symbiosum being least susceptible and accounting for most of the resistant isolates; excluding the aforementioned four resistant species, 86% (303 of 363) of Bacteroides species isolates and 94% (417 of 450) of all other genera and species were susceptible to <2 g/ml of moxifloxacin. Overall, moxifloxacin was active against 763 of 923 (83%) of strains at <2 g/ml, supporting its use as a monotherapy for some community-acquired intra-abdominal infections.Intra-abdominal infections are known to be composed of mixed aerobic and anaerobic bacteria (9). Current guidelines (22) recommend combining a fluoroquinolone with metronidazole for therapy of community-acquired intra-abdominal infections. Moxifloxacin, an 8-methoxyquinolone, has been reported to have activity against a broad spectrum of both aerobic and anaerobic bacteria (1, 4-6, 10, 14, 15, 25) such as encountered in intra-abdominal infections. However, many older in vitro studies employed a variety of media and methods and utilized isolates collected from a wide range of clinical sources. Moreover, older isolates may not reflect potential resistance that has since developed from use of the fluoroquinolones. Moxifloxacin has been reported to penetrate and accumulate in the human gastrointestinal mucosa (24) and a comparative mouse model study (19) has supported its use as a single agent in intra-abdominal infections. Clinical studies performed to evaluate the efficacy of moxifloxacin in mixed aerobic/anaerobic intra-abdominal infections have been reported in abstract form (M. Malangoni, J. Song, S. Choudri, P. Potgieter, and P. Cyrus, 44th Intersci. Conf. Antimicrob. Agents Chemother., abstr. L-990, 2004). In order to further evaluate its potential for this indication, we studied the comparative activity of moxifloxacin against 923 sequential anaerobic strains isolated from pretherapy cultures of patients with complicated intra-abdominal infections. MATERIALS AND METHODSIsolates were collected between 2001 and April 2004 from pretherapy clinical specimens from patients with complicated community-acquired intra-abdominal infections, some as part of a 56-site United States clinical trial for which we were a reference laboratory. The primary specimens were sent by overnight courier and cultured in our laboratory. All isolates were identified by standard criteria (13, 16) and some, when required, were identified by sequencing of the 16S RNA gene.Standard laboratory powders of the following antimcirobial agents were obtained as follows: moxifloxacin, Bayer Inc., West Haven, CT; levofloxacin, R.W. Johnson P...

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Clinical and microbiological efficacy of moxifloxacin versus amoxicillin/clavulanic acid in severe odontogenic abscesses: a pilot study

Al‐Nawas

Morbach

Seitner

et al. 2008

Eur J Clin Microbiol Infect Dis

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The aim of this study targeted the evaluation of the in vivo effect of moxifloxacin in the treatment of patients with severe odontogenic abscesses. This was a prospective, two-armed, randomised, unblinded, monocentric pilot study, which enrolled 21 hospitalized patients with severe odontogenic abscesses. After extraoral incision, patients were either treated with moxifloxacin 400 mg i.v. once daily or amoxicillin/clavulanic acid 2.2 g i.v. three times daily. Primary clinical endpoint was the time until clinical remission, represented by simultaneous assertion of the following criteria: body temperature <38.5 degrees C, no pain at palpation, and mouth opening similar or better than preoperatively. White blood cell count, C-reactive protein, pain, health related quality of life (HR-QoL) and length of hospital stay were recorded as secondary outcome criteria. The mean duration until reaching the primary end point was 6.6 (range, 4.3-8.8) days in the moxifloxacin group and 6.0 (range, 3.8-8.2) days in the amoxicillin/clavulanic acid group. Median days of in-house treatment ranged between five and six days for both groups. HR-QoL was highly impaired in both groups preoperatively and reached near normal on days three and four in both samples. In this pilot investigation, moxifloxacin showed promising results as compared to amoxicillin/clavulanic acid. Therefore, a larger prospective clinical trial using moxifloxacin in severe odontogenic abscesses appears encouraging. We suggest a combination of body temperature, palpatory pain, and subjective pain as a parameter for successful intervention; however, both findings need prospective validation by means of a phase III evaluation.

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Effect of moxifloxacin versus imipenem/cilastatin treatment on the mortality of mice infected intravenously with different strains of Bacteroides fragilis and Escherichia coli

Abstract: The data show that moxifloxacin was as efficacious as imipenem in reducing the mortality rate of mice suffering from a severe systemic aerobic/anaerobic infection.

Cited by 11 publications

References 41 publications

Activity of moxifloxacin against Bacteroides fragilis and Escherichia coli in an in vitro pharmacokinetic/pharmacodynamic model employing pure and mixed cultures

Activity of moxifloxacin against Bacteroides fragilis and Escherichia coli in an in vitro pharmacokinetic/pharmacodynamic model employing pure and mixed cultures

In Vitro Activity of Moxifloxacin against 923 Anaerobes Isolated from Human Intra-Abdominal Infections

Clinical and microbiological efficacy of moxifloxacin versus amoxicillin/clavulanic acid in severe odontogenic abscesses: a pilot study

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