title: Comparison of telavancin and vancomycin lock solutions in eradication of biofilm-producing staphylococci and enterococci from central venous catheters.
abstract: OBJECTIVE
  Results of a study of the activity of antibiotic lock solutions of vancomycin and telavancin against biofilm-forming strains of Staphylococcus epidermidis, Enterococcus faecalis, and Staphylococcus aureus are reported.
  
  
  METHODS
  An established in vitro central venous catheter model was used to evaluate lock solutions containing vancomycin (5 mg/mL) or telavancin (5 mg/mL), with and without preservative-containing heparin sodium (with 0.45% benzyl alcohol) 2500 units/mL, heparin, and 0.9% sodium chloride solution. Lock solutions were introduced after 24-hour bacterial growth in catheters incubated at 35 °C. After 72 hours of exposure to the lock solutions, catheters were drained, flushed, and cut into segments for quantification of colony-forming units.
  
  
  RESULTS
  Against S. epidermidis, vancomycin and telavancin (with or without heparin) had similar activity. Against E. faecalis, vancomycin alone was more active than telavancin alone (p < 0.01). Against S. aureus, vancomycin plus heparin had activity similar to that of vancomycin alone; both lock agents had greater activity than telavancin (p < 0.02). The addition of heparin was associated with reduced activity of the vancomycin lock solution against S. epidermidis and E. faecalis (p < 0.01). Telavancin activity was not significantly changed with the addition of heparin.
  
  
  CONCLUSIONS
  In a central venous catheter model, vancomycin and telavancin activity was similar in reducing biofilm-producing S. epidermidis. However, vancomycin was more active than telavancin against E. faecalis and S. aureus. None of the tested agents eradicated biofilm-forming strains. The addition of preservative-containing heparin sodium 2500 units/mL to vancomycin was associated with reduced activity against S. epidermidis and E. faecalis.
authors.affiliation: Rhode Island Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, and Department of Pharmacy Practice, University of Rhode Island, Kingston, RI.
authors.forename: Megan K
authors.initials: MK
authors.lastname: Luther
authors.affiliation: Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, and Rhode Island Hospital, Division of Infectious Diseases, Providence, RI.
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Mermel
authors.affiliation: Rhode Island Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, and Department of Pharmacy Practice, University of Rhode Island, Kingston, RI. kerrylaplante@uri.edu.
authors.forename: Kerry L
authors.initials: KL
authors.lastname: LaPlante
mesh_terms: D000617:Aminoglycosides / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D018441:Biofilms / Q000187:drug effects*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000188:drug therapy*; D062905:Central Venous Catheters / Q000382:microbiology; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D000077427:Lipoglycopeptides; D019999:Pharmaceutical Solutions / Q000008:administration & dosage; D013210:Staphylococcus / Q000187:drug effects* / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000077427:Lipoglycopeptides; D019999:Pharmaceutical Solutions; D014640:Vancomycin; C487637:telavancin