Successful moxifloxacin prophylaxis against experimental streptococcal aortic valve endocarditis.
OBJECTIVE
Studies related to the prophylactic efficacy of fluoroquinolones against infective endocarditis are scarce. The aim of this study was to evaluate the efficacy of moxifloxacin, a quinolone active in vitro against Gram-positive cocci, in preventing streptococcal aortic valve endocarditis.


METHODS
Non-bacterial thrombotic endocarditis of the aortic valve was induced by the insertion of a polyethylene catheter. Twenty-four hours later, rabbits were randomly assigned to a control group, and groups receiving either two doses of ampicillin (40 mg/kg, intravenously), 2 h apart, or a single dose of moxifloxacin (15 mg/kg, intravenously). Ampicillin and moxifloxacin were administered 0.5 and 1 h, respectively, prior to the intravenous inoculation of 10(7) cfu of Streptococcus oralis.


RESULTS
Eighty-nine percent of the control animals developed infected vegetations. In rabbits challenged with this very high inoculum, moxifloxacin and ampicillin prevented endocarditis in 80% (P < 0.001 versus controls) and in 50% (P = 0.022 versus controls) of animals, respectively. The difference between ampicillin and moxifloxacin was not statistically significant (P = 0.128).


CONCLUSIONS
Moxifloxacin was at least as effective as ampicillin in preventing streptococcal endocarditis.
Sakka
Vissaria
V
4th Department of Internal Medicine, General Hospital Attikon, University of Athens, Medical School, Athens, Greece.
Galani
Lambrini
L
Pefanis
Angelos
A
Iliopoulos
Dimitrios
D
Athanasopoulos
George
G
Donta
Ismini
I
Giamarellou
Helen
H
D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001021:Aortic Valve / Q000382:microbiology*; D001372:Aza Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D004195:Disease Models, Animal; D004697:Endocarditis, Bacterial / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D024841:Fluoroquinolones; D006349:Heart Valve Diseases / Q000473:pathology / Q000517:prevention & control*; D000077266:Moxifloxacin; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D011817:Rabbits; D013290:Streptococcal Infections / Q000473:pathology / Q000517:prevention & control*; D019533:Streptococcus oralis / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000667:Ampicillin; D000077266:Moxifloxacin