Efficacy of vancomycin, teicoplanin and fusidic acid as prophylactic agents in prevention of vascular graft infection: an experimental study in rat.
OBJECTIVE
To compare the efficacy of a single prophylactic dose of intra-peritoneal vancomycin and teicoplanin with anti-biotic treated Dacron grafts (vancomycin, teicoplanin, 10 or 40% fusidic acid-soaked grafts) in preventing vascular graft infections in a rat model.


METHODS
Prospective, randomized, controlled animal study.


METHODS
The graft infections were established in the subcutaneous tissues of 80 female Sprague-Dawley rats by the implantation of Dacron prostheses followed by the topical inoculation with methicillin-resistant Staphylococcus aureus. The study groups were as follows: (1) uncontaminated control group, (2) untreated contaminated group, (3) contaminated group with intra-peritoneal vancomycin, (4) contaminated group with intra-peritoneal teicoplanin, (5) contaminated group received vancomycin-soaked Dacron graft, (6) contaminated group received teicoplanin-soaked Dacron graft, (7) contaminated group received 40% fusidic acid-soaked Dacron graft, and (8) contaminated group received 10% fusidic acid-soaked Dacron graft prophylaxis. The grafts were removed after 7 days and evaluated by a quantitative culture analysis.


RESULTS
No infection was detected in controls. The untreated contaminated group had a high bacteria count (6.0 x 10(4) CFU/cm2 Dacron graft). Groups that received intra-peritoneal vancomycin or teicoplanin had less bacterial growth (4.8 x 10(3) and 3.9 x 10(3)CFU/cm2 Dacron graft, respectively). Similarly, the group that received 10% fusidic acid-soaked graft showed less bacterial growth (3.6 x 10(3) CFU/cm2 Dacron graft). The groups with vancomycin-, teicoplanin- and 40% fusidic acid-soaked grafts showed no evidence of infection. Statistical analyses demonstrated that intra-peritoneal prophylactic antibiotic treatment was less effective in inhibiting bacterial growth than high concentration antimicrobial-soaking of grafts.


CONCLUSIONS
The use of vancomycin-, teicoplanin- and 40% fusidic acid-soaked grafts was effective in preventing primary prosthetic vascular graft infection.
Yasim
A
A
Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Turkey. alpyasim@ksu.edu.tr
Gul
M
M
Atahan
E
E
Ciragil
P
P
Aral
M
M
Ergun
Y
Y
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005260:Female; D005672:Fusidic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D007263:Infusions, Parenteral; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D017334:Teicoplanin / Q000008:administration & dosage / Q000627:therapeutic use*; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D005672:Fusidic Acid; D017334:Teicoplanin; D014640:Vancomycin