Therapy of experimental Pseudomonas endocarditis with high-dose amikacin and ticarcillin.
Right-sided infective endocarditis due to Pseudomonas aeruginosa was induced in 130 rabbits. Animals received either: (1) no therapy (controls); (2) standard-dose amikacin (AMK) (15 mg/kg/day) plus ticarcillin (300 mg/kg/day), or (3) high-dose AMK (20 or 25 mg/kg/day) plus ticarcillin, for 20 days. Animals in each treatment group were evaluated at 10 days after therapy for bacteriologic relapse. Both standard- and high-dose AMK regimens significantly decreased mortality and Pseudomonas aeruginosa vegetation titers versus controls (p less than 0.01, p less than 0.05, respectively). Despite significantly higher serum AMK levels at 25 mg/kg/day, there was no significant difference in mean vegetation titers, percent of vegetations sterilized, or posttherapy bacteriologic relapse in the three treatment groups. AMK at 20 or 25 mg/kg/day (but not at 15 mg/kg/day) significantly reduced the incidence of pulmonary infarction versus untreated controls (p less than 0.01).
D000583:Amikacin / Q000627:therapeutic use*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000097:blood; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D007612:Kanamycin / Q000031:analogs & derivatives*; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000627:therapeutic use*; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011817:Rabbits; D013982:Ticarcillin / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D007612:Kanamycin; D000583:Amikacin; D013982:Ticarcillin