title: Antimicrobials as potential adjunctive agents in the treatment of biofilm infection with Staphylococcus epidermidis.
abstract: BACKGROUND
  This study was performed to evaluate the interaction of erythromycin or rifampin with vancomycin against Staphylococcus epidermidis biofilms.
  
  
  METHODS
  Biofilm-forming S. epidermidis strains (ATCC 35983, 35984) and polyurethane (PU) sheets were incubated for the formation of bacterial biofilms. Biofilms on PU sheets were treated with various antibiotic regimens. The number of viable bacteria on the sheets was counted.
  
  
  RESULTS
  While erythromycin or vancomycin alone did not significantly reduce the biofilm bacterial concentration, the combination of vancomycin and erythromycin resulted in a clear reduction in bacterial concentration compared with the single agents. Rifampin was the most active single agent against biofilm-forming S. epidermidis, while the combination of rifampin and vancomycin showed further reduction in bacterial concentration.
  
  
  CONCLUSIONS
  These data suggest that the combination of erythromycin or rifampin and vancomycin is more effective than vancomycin alone in the treatment of biofilm infections caused by biofilm-forming S. epidermidis.
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. krpeck@smc.samsung.kr
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Shin Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Sook-In
authors.initials: SI
authors.lastname: Jung
authors.forename: Yeon-Sook
authors.initials: YS
authors.lastname: Kim
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Oh
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Joung Hwa
authors.initials: JH
authors.lastname: Jin
authors.forename: Sungmin
authors.initials: S
authors.lastname: Kim
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D018441:Biofilms / Q000187:drug effects*; D015169:Colony Count, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004917:Erythromycin / Q000627:therapeutic use; D006801:Humans; D011140:Polyurethanes; D016459:Prosthesis-Related Infections / Q000188:drug therapy*; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000254:growth & development; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D011140:Polyurethanes; D004917:Erythromycin; D014640:Vancomycin; D012293:Rifampin