Treatment evaluation of experimental staphylococcal infections: comparison of beta-lactam, lipopeptide, and glycopeptide antimicrobial therapy.
LY 146032, teicoplanin, vancomycin, oxacillin, cephalothin, cefamandole, ampicillin plus sulbactam, and cefoperazone plus sulbactam were studied against six isolates of staphylococci (including both Staphylococcus aureus and coagulase negative staphylococci) using in vivo and in vitro methods. In vitro susceptibility measurements demonstrated that all six isolates were sensitive to LY 146032 and vancomycin and that five of six isolates were sensitive to tiecoplanin, cefamandole, ampicillin plus sulbactam, and cefoperazone plus sulbactam. Comparison of antimicrobial therapy in an in vivo rabbit model demonstrated that cefoperazone plus sulbactam was active against the greatest number of isolates (five of six) based on a reduction of greater than or equal to 5.0 log10 colony forming units per milliliter (CFU/ml) from growth control at the end of the animal treatment study. Vancomycin and oxacillin were equal in achieving reductions of greater than or equal to 5.0 log10 CFU/ml in four of the six isolates. Comparing each isolate's in vivo outcome to in vitro data shows that in vitro susceptibility tests overpredict the sensitivity of these six isolates to LY 146032 and vancomycin, are variable for teicoplanin, cefamandole, ampicillin plus sulbactam, and cefoperazone plus sulbactam, and underpredict for oxacillin.
Fasching
C E
CE
Infectious Disease Section, Department of Veterans Affairs Medical Center, Minneapolis, Minnesota 55417.
Peterson
L R
LR
Moody
J A
JA
Sinn
L M
LM
Gerding
D N
DN
D000667:Ampicillin / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002435:Cefamandole / Q000627:therapeutic use; D002438:Cefoperazone / Q000627:therapeutic use; D002512:Cephalothin / Q000627:therapeutic use; D017576:Daptomycin; D004195:Disease Models, Animal; D005260:Female; D006020:Glycopeptides / Q000627:therapeutic use*; D010068:Oxacillin / Q000627:therapeutic use; D010455:Peptides / Q000627:therapeutic use; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013407:Sulbactam / Q000627:therapeutic use; D017334:Teicoplanin; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D010455:Peptides; D002435:Cefamandole; D017334:Teicoplanin; D014640:Vancomycin; D000667:Ampicillin; D002438:Cefoperazone; D017576:Daptomycin; D002512:Cephalothin; D013407:Sulbactam; D010068:Oxacillin