Comparative prophylactic efficacy of cefazolin and vancomycin in a guinea pig model of Staphylococcus aureus wound infection.
The increasing prevalence of methicillin-resistant Staphylococcus aureus as a wound pathogen in some institutions has prompted the use of vancomycin for surgical prophylaxis, although clinical data comparing vancomycin and cephalosporins are not available. A guinea pig model was used to compare the efficacy of vancomycin and cefazolin in preventing intermuscular abscess formation by 7 S. aureus strains. Both antibiotics were administered to achieve peak serum levels at the time of bacterial inoculation, and each remained > 1 micrograms/mL for a comparable duration. Vancomycin provided equivalent protection from infection by 1 methicillin-susceptible strain and significantly better protection against 4 methicillin-susceptible and both methicillin-resistant S. aureus strains. For most strains, the bacterial inoculum with a 50% probability of causing an abscess was 2 to 4 log10-fold higher with vancomycin than cefazolin prophylaxis. Prophylaxis with vancomycin is superior to cefazolin in preventing intermuscular infection by methicillin-susceptible and -resistant S. aureus.
Kernodle
D S
DS
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee.
Kaiser
A B
AB
D000818:Animals; D002437:Cefazolin / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005260:Female; D006168:Guinea Pigs; D008297:Male; D012044:Regression Analysis; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus; D014640:Vancomycin / Q000627:therapeutic use*; D014946:Wound Infection / Q000188:drug therapy*
D014640:Vancomycin; D002437:Cefazolin