Quinupristin/dalfopristin bonding in combination with intraperitoneal antibiotics prevent infection of knitted polyester graft material in a subcutaneous rat pouch model infected with resistant Staphylococcus epidermidis.
OBJECTIVE
to investigate the efficacy of quinupristin/dalfopristin in the prevention of prosthetic graft infection in a rat subcutaneous pouch model.


METHODS
graft infections were established in the subcutaneous tissue of 140 male Wistar rats by implantation of Dacron prostheses followed by topical inoculation with Staphylococcus epidermidis with intermediate resistance to glycopeptides. The study included one group without contamination, one contaminated group without prophylaxis, one contaminated group that received 50mg/l quinupristin/dalfopristin-soaked graft, one contaminated group that received 10mg/kg intraperitoneal levofloxacin, one contaminated group that received 3mg/kg intraperitoneal doxycycline, and two contaminated groups that received 50mg/l quinupristin/dalfopristin-soaked plus 10mg/kg intraperitoneal levofloxacin or 3mg/kg intraperitoneal doxycycline. Each group included 20 animals. The grafts were removed after 7 days and evaluated by quantitative culture.


RESULTS
quinupristin/dalfopristin showed a significantly higher efficacy than levofloxacin and doxycycline, even though quantitative graft cultures for rats that received only quinupristin/dalfopristin-soaked graft showed bacterial growth. Otherwise, the efficacy of levofloxacin was similar to that of doxycycline. Only the group treated with quinupristin/dalfopristin combined with levofloxacin or doxycycline showed no evidence of staphylococcal infection.


CONCLUSIONS
quinupristin/dalfopristin as adjunctive topical antibiotic prophylaxis can be useful for the prevention of vascular graft infections caused by staphylococcal strains with high levels of resistance.
Ghiselli
R
R
Department of General Surgery, I.N.R.C.A. I.R.C.C.S. University of Ancona, Ancona, Italy.
Giacometti
A
A
Cirioni
O
O
Mocchegiani
F
F
Orlando
F
F
Del Prete
M
M
D'Amato
G
G
Scalise
G
G
Saba
V
V
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D004195:Disease Models, Animal; D004318:Doxycycline / Q000008:administration & dosage* / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D007274:Injections, Intraperitoneal; D064704:Levofloxacin; D008297:Male; D015242:Ofloxacin / Q000008:administration & dosage* / Q000627:therapeutic use*; D011091:Polyesters / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000517:prevention & control*; D051381:Rats; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013212:Staphylococcus epidermidis / Q000472:pathogenicity*; D014769:Virginiamycin / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D011091:Polyesters; D014769:Virginiamycin; C062940:quinupristin-dalfopristin; D064704:Levofloxacin; D015242:Ofloxacin; D004318:Doxycycline