Efficacy of antibiotic-coated catheters in preventing subcutaneous Staphylococcus aureus infection in rabbits.
Vascular catheters coated with antiinfective compounds were evaluated as to their ability to prevent Staphylococcus aureus catheter infection in a rabbit model. Zones of inhibition of agar surface-plated S. aureus demonstrated the following hierarchy: dicloxacillin and clindamycin were each better than fusidic acid or chlorhexidine, which were better than ciprofloxacin, cefotaxime, or cefuroxime. In vivo half-lives of inhibitory activity for clindamycin and dicloxacillin were 5.6 and 17.7 h, respectively, with apparent first-order kinetics. Chlorhexidine disappeared in vivo with apparent two-compartment kinetics: first-compartment t1/2, 16.8 h; second-compartment t1/2, 115.6 h. In a rabbit model, dicloxacillin, clindamycin, fusidic acid, and chlorhexidine decreased the risk of infection compared with uncoated control catheters (P < .05). For dicloxacillin, clindamycin, and chlorhexidine, this was true even if the S. aureus inoculation was delayed 48 or 96 h after catheter implantation. These data suggest that vascular catheters with antiinfective coatings should be investigated further in hospitalized patients.
Sherertz
R J
RJ
Department of Medicine, Wake Forest Medical Center, Winston-Salem, North Carolina 27157-1042.
Carruth
W A
WA
Hampton
A A
AA
Byron
M P
MP
Solomon
D D
DD
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002404:Catheterization / Q000009:adverse effects*; D002408:Catheters, Indwelling; D002710:Chlorhexidine / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D002981:Clindamycin / Q000494:pharmacology; D004009:Dicloxacillin / Q000494:pharmacology; D005672:Fusidic Acid / Q000494:pharmacology; D006207:Half-Life; D011817:Rabbits; D013203:Staphylococcal Infections / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D005672:Fusidic Acid; D002939:Ciprofloxacin; D004009:Dicloxacillin; D002710:Chlorhexidine