Efficacy of teicoplanin, administered in two different regimens, in the treatment of experimental endocarditis due to Enterococcus faecalis.
Using a rabbit model of endocarditis, we studied the efficacy of teicoplanin against a strain of Enterococcus faecalis resistant to ampicillin. Rabbits were randomly assigned to receive no antibiotics, teicoplanin 12 or 18 mg/kg of body weight every 12h, for 9 days. The effect of treatment on bacterial counts of vegetations and survival of the animals was evaluated at the end of treatment and 10 days thereafter. The two treatment regimens of teicoplanin produced peak serum levels 18.51+/-1.84 and 34.66+/-4.19 microg/ml, and trough levels above 10 x MIC of teicoplanin for the infecting organism. Both regimens resulted in significant bacterial reduction in the vegetations as compared to the control group (p<0.001). The drug prevented relapse of the infection 10 days after discontinuation of treatment. By increasing the teicoplanin dosage no additional therapeutic benefit was observed in terms of bacterial killing, sterilization of the vegetations, and survival of the animals, although the higher doses gave numerically superior results. These findings may have meaning for the optimum use of teicoplanin in the treatment of enterococcal endocarditis.
Pavleas
J
J
Intensive Care Unit, Laikon General Hospital, Athens, Greece. ipavleas@yahoo.com
Skiada
A
A
Daikos
G L
GL
Pefanis
A
A
Giamarellos-Bourboulis
E
E
Kanellakopoulou
K
K
Tsaganos
T
T
Perrea
D
D
Donta
I
I
Karayannakos
P
P
Giamarellou
H
H
D000668:Ampicillin Resistance; D000818:Animals; D000900:Anti-Bacterial Agents / Q000097:blood / Q000627:therapeutic use*; D001021:Aortic Valve / Q000382:microbiology*; D004305:Dose-Response Relationship, Drug; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D013293:Enterococcus faecalis / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D011817:Rabbits; D017334:Teicoplanin / Q000097:blood / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D017334:Teicoplanin