Chemoprophylactic efficacy against experimental endocarditis caused by beta-lactamase-producing, aminoglycoside-resistant enterococci is associated with prolonged serum inhibitory activity.

Antimicrobial Agents and Chemotherapy
A S Bayer, J Tu

Abstract

We studied the prevention of experimental aortic endocarditis caused by a beta-lactamase-producing, aminoglycoside-resistant strain of Enterococcus faecalis (HH22) in 146 catheterized rabbits. Both vancomycin and ampicillin-sulbactam readily killed this resistant enterococcus strain in vitro. At a challenge inoculum of approximately 10(9) CFU, vancomycin (40 mg/kg intravenously [i.v.]), ampicillin (40 mg/kg i.v.), or a combination of ampicillin plus a beta-lactamase inhibitor, sulbactam (20 mg/kg, i.v.), did not prevent the development of endocarditis in any of the animals, although mean intravegetation bacterial densities were significantly lower in animals that received vancomycin than they were in animals that received other therapies (P less than 0.001). At a challenge inoculum of 10(6) CFU, vancomycin was 100% effective in preventing enterococcal endocarditis compared with ampicillin (29%; P less than 0.00001) and ampicillin-sulbactam (65%; P less than 0.01). Factors associated with the superior prophylactic efficacy of vancomycin in this model included prolonged serum inhibitory activity and time above MICs. Factors not associated with the antienterococcal prophylactic efficacy of vancomycin included the duration of the i...Continue Reading

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Citations

Apr 6, 1999·APMIS. Supplementum·K Fuursted
Nov 1, 1992·Antimicrobial Agents and Chemotherapy·B E Murray
Dec 1, 1994·Antimicrobial Agents and Chemotherapy·U FluckigerP Francioli
Aug 22, 2000·Antimicrobial Agents and Chemotherapy·I KatsarolisH Giamarellou
Jan 27, 2006·Antimicrobial Agents and Chemotherapy·George AthanassopoulosHelen Giamarellou
Oct 6, 2005·The Journal of Antimicrobial Chemotherapy·Vissaria SakkaHelen Giamarellou

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