Successful single-dose teicoplanin prophylaxis against experimental streptococcal, enterococcal, and staphylococcal aortic valve endocarditis.
Teicoplanin is a glycopeptide antibiotic that is administered both intramuscularly and intravenously. It has a prolonged half-life and a less toxic profile in comparison to those of vancomycin. The efficacy of a single dose of teicoplanin (18 mg/kg of body weight given intramuscularly) for the prevention of endocarditis due to Streptococcus oralis, Enterococcus faecium, and methicillin-resistant Staphylococcus aureus (MRSA) was evaluated after applying the rabbit model. Vancomycin at a single dose of 30 mg/kg given intravenously was used as the comparative agent for the prevention of endocarditis due to MRSA and E. faecium, while ampicillin at a single dose of 40 mg/kg given intravenously was used as the comparative agent for the prevention of endocarditis due to S. oralis. Rabbits in the teicoplanin group were infected at 1 h postdosing with approximately 10(7) CFU of each strain. Rabbits in the other groups were infected at 0.5 h postdosing with approximately 10(7) CFU of S. oralis (ampicillin group) or E. faecium and MRSA (vancomycin group). All rabbits were sacrificed 5 days later. Teicoplanin and vancomycin protected the animals challenged with E. faecium by 87.5 and 50%, respectively, and protected the animals challenged with MRSA by 100 and 92%, respectively. Teicoplanin and ampicillin protected the animals challenged with S. oralis by 100 and 77%, respectively. Prevention of endocarditis by teicoplanin was likely to be due to a prolonged inhibition of bacterial growth by the sustained supra-MICs. It is concluded that teicoplanin is very effective in preventing experimental streptococcal, enterococcal, and staphylococcal endocarditis and may be an attractive alternative antibiotic in patients allergic to beta-lactams, especially in the outpatient setting.
Perdikaris
G S
GS
1st Department of Propedeutic Medicine, Laiko General Hospital, Athens, Greece.
Pefanis
A
A
Giamarellou
H
H
Nikolopoulos
A
A
Margaris
E P
EP
Donta
I
I
Tsitsika
A
A
Karayiannakos
P
P
D000818:Animals; D000900:Anti-Bacterial Agents / Q000097:blood / Q000627:therapeutic use*; D001018:Aortic Diseases / Q000097:blood / Q000517:prevention & control; D001021:Aortic Valve; D004334:Drug Administration Schedule; D004697:Endocarditis, Bacterial / Q000097:blood / Q000517:prevention & control*; D013293:Enterococcus faecalis / Q000187:drug effects; D005260:Female; D016908:Gram-Positive Bacterial Infections; D008826:Microbial Sensitivity Tests; D011817:Rabbits; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus / Q000187:drug effects; D013290:Streptococcal Infections; D019533:Streptococcus oralis / Q000187:drug effects; D017334:Teicoplanin / Q000097:blood / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D017334:Teicoplanin