Single-Dose Rifampin Prophylaxis for Experimental Endocarditis Induced by High Bacterial Inocula of Viridans Streptococci

Malinvemi, R.; Billé, Jacques; Glauser, M. P.

doi:10.1093/infdis/156.1.151

Cited by 11 publications

(1 citation statement)

References 20 publications

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“…In the absence of bacterial killing, early studies (2, 7) have suggested that the inhibition of bacterial adherence to vegetations was the mechanism by which prophylaxis prevented endocarditis. However, recent observations (13,17) have shown that prolonged inhibition of bacterial growth after the intravenous challenge, rather than inhibition of bacterial adherence, was likely to be the mechanism of protection. The longer the duration of growth inhibition is, the greater the likelihood of successful prophylaxis after challenge with inocula exceeding the ID90 is.…”

Section: Discussionmentioning

confidence: 99%

Teicoplanin versus vancomycin for prophylaxis of experimental Enterococcus faecalis endocarditis in rats

Entenza

Calandra

Moosmann

et al. 1992

Antimicrob Agents Chemother

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Teicoplanin was compared with vancomycin for the prophylaxis of experimental Enterococcus faecalis endocarditis in rats. Single intravenous doses of teicoplanin (7 mg/kg of body weight) or vancomycin (15 mg/kg) were given 30 min before bacterial challenge. Two strains of E. faecalis (309 and 1209) isolated from patients with endocarditis were tested. Bacterial inocula ranged from 104 (i.e., the inoculum infecting 90%o of the control rats [ID901) to 107 CFU/ml. The MICs and MBCs of teicoplanin and vancomycin were, respectively, 0.25 to > 128 mg/liter and 2 to > 128 mg/liter for strain 309 and 0.5 to > 128 mg/liter and 0.5 to > 128 mg/liter for strain 1209. Vancomycin prevented endocarditis only in 60% (strain 309) and in 87% (strain 1209) of rats challenged with the smallest bacterial-inoculum size (ID0), whereas teicoplanin prevented endocarditis in 100% of rats challenged with the same inoculum (strain 309; P = 0.05), in 87% of rats challenged with 10 times the ID90 (strain 309; P = 0.02), and in 95% of rats challenged with 100 times the ID90 (strain 1209; P = 0.0003). The combination of teicoplanin plus gentamicift (4 mg/kg) extended the protection to inocula 100 times the ID90 (strain 309; 96% of sterile animals) and 1,000 times the ID90 (strain 1209; 100%o of sterile animals). Prevention of endocarditis was likely to be due to a prolonged inhibition of bacterial growth by sustained levels of teicoplanin in serum and not to bacterial killing. Indeed, teicoplanin did not exhibit any bactericidal activity either in vitro (time-kill curves) or in vivo (serum bactericidal activity). Teicoplanin proved to be superior to vancomycin in the prophylaxis of experimental E. faecalis endocarditis in rats.Teicoplanin is a glycopeptide antibiotic chemically related to vancomycin (20). These two antibiotics have similar modes of action (26) and comparable in vitro activities against a wide spectrum of gram-positive bacteria, including enterococci and methicillin-susceptible and methicillin-resistant staphylococci (8,18,19). Unlike vancomycin, however, teicoplanin displays an extremely long half-life in plasma in vivo, allowing once-daily administration, and is well tolerated when given intramuscularly (28,29). In view of its spectrum of antibacterial activity and its pharmacokinetic properties, teicoplanin may be an alternative to vancomycin.Enterococcal endocarditis is the third most common cause of infective endocarditis (12) and is difficult to treat because of an increased resistance to P-lactam antibiotics and aminoglycosides (10). In patients allergic to P-lactam antibiotics, vancomycin is the recommended antibiotic for the prophylaxis of bacterial endocarditis, especially in patients undergoing gastrointestinal or genitourinary procedures (4,23,24). The aim of the present study was to investigate the efficacy of teicoplanin for the prophylaxis of experimental Enterococcus faecalis endocarditis in rats and to compare it with that of vancomycin.( MATERIALS AND METHODSMicroorganisms. We used two strains of E. faecalis...

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Section: Discussionmentioning

confidence: 99%

Teicoplanin versus vancomycin for prophylaxis of experimental Enterococcus faecalis endocarditis in rats

Entenza

Calandra

Moosmann

et al. 1992

Antimicrob Agents Chemother

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Antimicrobial prophylaxis of experimental endocarditis caused by staphylococcus epidermidis

1989

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Using two different strains of Staphylococcus epidermidis in a rat model of experimental endocarditis, we examined the prophylactic efficacy of cefamandole (200 mg/kg/dose), cefazolin (200 mg/kg/dose), nafcillin (200 mg/kg/dose), and vancomycin (20 mg/kg/dose). In vitro susceptibility testing demonstrated that both test strains were resistant to methicillin and cefazolin and susceptible to cefamandole and vancomycin. A 10(6) cfu inoculum was used for both strains, an inoculum which produced endocardial infections in greater than 90% of rats. Initial doses of each antibiotic were given 45 min to 1 h prior to bacterial challenge and were followed by six additional doses of each antibiotic administered subcutaneously every 6 h. The efficacy rates of cefamandole (84.0%) and cefazolin (70.8%) were exactly the same for rats infected with either S. epidermidis strain. Similar efficacy rates were seen in rats infected with either strain and treated with vancomycin (94.4% and 86.7%). Unlike the other three drugs, the efficacy of nafcillin was quite different in rats challenged with the two strains (62.5% and 38.5%, p = 0.19). It appears that cefamandole and cefazolin may have considerable prophylactic efficacy against certain infecting strains of methicillin-resistant, coagulase-negative staphylococci when relatively large doses of cephalosporins are administered subcutaneously in this animal model.

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Animal models of endocarditis

Carbon

1994

International Journal of Bio-Medical Computing

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Single-Dose Rifampin Prophylaxis for Experimental Endocarditis Induced by High Bacterial Inocula of Viridans Streptococci

Cited by 11 publications

References 20 publications

Teicoplanin versus vancomycin for prophylaxis of experimental Enterococcus faecalis endocarditis in rats

Teicoplanin versus vancomycin for prophylaxis of experimental Enterococcus faecalis endocarditis in rats

Antimicrobial prophylaxis of experimental endocarditis caused by staphylococcus epidermidis

Animal models of endocarditis

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