Daptomycin is highly efficacious against penicillin-resistant and penicillin- and quinolone-resistant pneumococci in experimental meningitis.
The penetration of daptomycin, a new lipopeptide antibiotic, into inflamed meninges ranged between 4.37 and 7.53% (mean, 5.97%). Daptomycin was very efficacious in the treatment of experimental pneumococcal meningitis, producing a decrease of -1.20 +/- 0.32 Deltalog(10) CFU/ml. h in the bacterial titer of Streptococcus pneumoniae against a penicillin-resistant strain and of -0.97 +/- 0.32 Deltalog(10) CFU/ml. h against a penicillin- and quinolone-resistant strain found in cerebrospinal fluid (CSF). For both strains, daptomycin was significantly superior to the standard regimen of a combination of ceftriaxone with vancomycin, sterilizing 9 of 10 CSF samples after 4 h. In vitro, daptomycin produced highly bactericidal activity in concentrations above the MIC.
Cottagnoud
Philippe
P
Department of Internal Medicine, Inselspital, Bern, Switzerland. pcottagn@insel.ch
Pfister
Marc
M
Acosta
Fernando
F
Cottagnoud
Marianne
M
Flatz
Lukas
L
Kühn
Felix
F
Müller
Hans-Peter
HP
Stucki
Armin
A
D000818:Animals; D000900:Anti-Bacterial Agents / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000494:pharmacology*; D019540:Area Under Curve; D017576:Daptomycin / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D024881:Drug Resistance, Bacterial; D007700:Kinetics; D008578:Meninges / Q000378:metabolism; D008586:Meningitis, Pneumococcal / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D009154:Mutation / Q000235:genetics; D010403:Penicillin Resistance; D015363:Quinolones / Q000494:pharmacology*; D011817:Rabbits; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000235:genetics; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D015363:Quinolones; D014640:Vancomycin; D017576:Daptomycin