title: Staphylococcus epidermidis biofilms: unexpected outcome of double and triple antibiotic combinations with rifampin.
abstract: Staphylococcus epidermidis, in contact with artificial surfaces, may produce a protective glue-like matrix or biofilm. The authors demonstrated that rifampin alone among 35 antibiotics penetrated the biofilm within a 24 hr exposure producing a major but incomplete killing. Antibiotics of the cell-wall active class (including vancomycin) were synergistic with rifampin, completing the bactericidal action. The addition of these antibiotics to a rifampin-vancomycin combination did not alter the synergy. Other antibiotics (including aminoglycosides) antagonized rifampin activity. This antagonism of rifampin was maintained when the antibiotics were added to the rifampin-vancomycin synergistic combination. These results may have implications for the choice of optimal therapeutic regimens in the management of implant-associated infection.
authors.affiliation: Department of Medicine, Montreal General Hospital, P.Q., Canada.
authors.forename: R F
authors.initials: RF
authors.lastname: Gagnon
authors.forename: G K
authors.initials: GK
authors.lastname: Richards
authors.forename: L
authors.initials: L
authors.lastname: Wiesenfeld
mesh_terms: D004359:Drug Therapy, Combination / Q000494:pharmacology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012293:Rifampin / Q000494:pharmacology*; D013212:Staphylococcus epidermidis / Q000187:drug effects*; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D014640:Vancomycin; D012293:Rifampin