Infect Chemother.  2008 Apr;40(2):102-106. 10.3947/ic.2008.40.2.102.

Efficacy of the Arbekacin and Teicoplanin Combination on Glycopeptide Intermediate Staphylococcus aureus in a Rabbit Model of Endocarditis

• Cho CH
• Choi JY
• Han SH
• Lee HS
• Choi SH
• Chin BS
• Choi HK
• Jeoung SJ
• Kim MS
• Kim CO
• Kim CK
• Yong D
• Song YG
• Lee K
• Kim JM

• KMID: 2230012
• DOI: http://doi.org/10.3947/ic.2008.40.2.102

Abstract

BACKGROUND: There have been no reports to evaluate the usefulness of combination therapy with glycopeptide and arbekacin in endocarditis by in vivo model.
MATERIALS AND METHODS
We investigated the efficacy of the arbekacin and teicoplanin combination on glycopeptide intermediate Staphylococcus aureus (GISA) in rabbit model of endocardits. GISA Mu50 strain was used for the experiment. The rabbit model of aortic valve endocarditis as described previously was used. Treatment was started 20h later inoculation with teicoplanin alone (at 20 mg/kg of body weight intramuscularly every 12 hours for 4 days after loading dose of 40 mg/kg of body weight intramuscularly), arbekacin alone (5 mg/kg of body weight intramuscularly every 12h for 4 days), or teicoplanin plus arbekacin. The results of therapy for experimental endocarditis due to Mu50 showed that teicoplanin and arbekacin combination was more effective than the administration of both drugs alone in reducing the log10CFU/g of aortic vegetation (P<0.05).
CONCLUSION
The combination of teicoplanin and arbekacin was more effective against GISA (Mu50) than both drugs alone in vivo endocarditis model.

Keyword

Endocarditis; Staphylococcus aureus; Teicoplanin; Arbekacin

MeSH Terms

Aortic Valve
Body Weight
Dibekacin
Endocarditis
Sprains and Strains
Staphylococcus
Staphylococcus aureus
Teicoplanin
Dibekacin
Teicoplanin

Reference

1. Moore MR, Perdreau-Remington F, Chambers HF. Vancomycn treatment failure associated with heterogeneous vancomycin-intermediate Staphylococcus aureus in a patient with endocarditis and in the rabbit model of endocarditis. Antimicrob Agents Chemother. 2003. 47:1262–1266.

2. Pavie J, Lefort A, Ploy MC, Massias L, Chau F, Garry L, Denis F, Fantin B. Influence of reduced susceptibility to glycopeptides on activities of vancomycin and teicoplanin against Staphylococcus aureus in experimental endocarditis. Antimicrob Agents Chemother. 2003. 47:2018–2021.

3. Perry JD, Jones AL, Gould FK. Glycopeptide tolerance in bacteria causing endocarditis. J Antmicrob Chemother. 1999. 44:121–124.

4. Hanaki H, Hiramatsu K. Combination effect of teicoplanin and various antibiotics against hetero-VRSA and VRSA. Kansenshogaku Zasshi. 1999. 73:1048–1053.

5. Lee JY, Oh WS, Ko KS, Heo ST, Moon CS, Ki HK, Keim S, Peck KR, Song JH. Synergy of arbekacin-based combinations against vancomycin hetero-intermediate Staphylococcus aureus. J Korean Med Sci. 2006. 21:188–192.

6. National Committee for Clinical Laboratory Standards Institute. Performance standards for antimicrobial disk susceptibility test, approved standards. 2003. 8th ed. Wayne. PA: CLSI.

7. Perlman BB, Freedman LR. Experimental endocarditis. II: Staphylococcal infection of the aortic valve following placement of a polyethylene catheter in the left side of the heart. Yale J Biol Med. 1971. 44:206–213.

8. Kak V, Donabedian SM, Zervos MJ, Kariyama R, Kumon H, Chow JW. Efficacy of ampicillin plus arbekacin in experimental rabbit endocarditis caused by an Enterococcus faecalis strain with high-level gentamicin resistance. Antimicrob Agents Chemother. 2000. 44:2545–2546.

9. Fantin B, Leclercq R, Arthur M, Duval J, Carbon C. Influence of low-level resistance to vancomycin on efficacy of teicoplanin and vancomycin for treatment of experimental endocarditis due to Enterococcus faecium. Antimicrob Agents Chemother. 1991. 35:1570–1575.

10. Leclercq R, Derlot E, Duval J, Courvalin P. Plasmid mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med. 1988. 319:157–161.

11. Hiramatsu K, Hanaki H, Ino T, Yabuta K, Oguri T, Tenover FC. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother. 1997. 40:135–136.

12. Hiramatsu K. Vancomycin resistance staphylococci. Drug Resistance Updat. 1998. 1:135–150.

13. Levine DP, Fromm BS, Reddy BR. Slow response to vancomycin or vancomycin plus rifampin in methicillin-resistant Staphylococcus aureus endocarditis. Ann Intern Med. 1991. 115:674–680.

14. Ubukata K, Yamashita N, Gotoh A, Konno M. Purification and characterization of aminoglycoside-modifying enzymes from Staphylococcus aureus and Staphylococcus epidermidis. Antimicrob Agents Chemother. 1984. 25:754–759.

15. Kondo S, Iinuma K, Yamamoto H, Maeda K, Umezawa H. Synthesis of 1-n-{(S)-4-amino-2-hydroxybutytyl)}-kanamycin B and 3'-,4'-dideoxykanamycin B active against kanamycin resistant bacteria. J Antibiot. 1973. 26:412–415.

16. Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 2005. 6th ed. Philadelphia: Elsevier;994.

17. Gilbert DN, Wood CA, Kimbrough RC. Failure of treatment with teicoplanin at 6 milligrams/kilogram/day in patients with Staphylococcus aureus intravascular infection. The Infectious Diseases Consortium of Oregon. Antimicrob Agents Chemother. 1991. 35:79–87.