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Evaluation of high-dose daptomycin for therapy of experimental Staphylococcus aureus foreign body infection

Schaad, H. J.
Bento, Manuela
Published in BMC Infectious Diseases. 2006, vol. 6, p. 74
Abstract BACKGROUND: Daptomycin is a novel cyclic lipopeptide whose bactericidal activity is not affected by current antibiotic resistance mechanisms displayed by S. aureus clinical isolates. This study reports the therapeutic activity of high-dose daptomycin compared to standard regimens of oxacillin and vancomycin in a difficult-to-treat, rat tissue cage model of experimental therapy of chronic S. aureus foreign body infection. METHODS: The methicillin-susceptible S. aureus (MSSA) strain I20 is a clinical isolate from catheter-related sepsis. MICs, MBCs, and time-kill curves of each antibiotic were evaluated as recommended by NCCLS, including supplementation with physiological levels (50 mg/L) of Ca2+ for daptomycin. Two weeks after local infection of subcutaneously implanted tissue cages with MSSA I20, each animal received (i.p.) twice-daily doses of daptomycin, oxacillin, or vancomycin for 7 days, or was left untreated. The reductions of CFU counts in each treatment group were analysed by ANOVA and Newman-Keuls multiple comparisons procedures. RESULTS: The MICs and MBCs of daptomycin, oxacillin, or vancomycin for MSSA strain I20 were 0.5 and 1, 0.5 and 1, or 1 and 2 mg/L, respectively. In vitro elimination of strain I20 was more rapid with 8 mg/L of daptomycin compared to oxacillin or vancomycin. Twice-daily administered daptomycin (30 mg/kg), oxacillin (200 mg/kg), or vancomycin (50 mg/kg vancomycin) yielded bactericidal antibiotic levels in infected cage fluids throughout therapy. Before therapy, mean (+/- SEM) viable counts of strain I20 were 6.68 +/- 0.10 log10 CFU/mL of cage fluid (n = 74). After 7 days of therapy, the mean (+/- SEM) reduction in viable counts of MSSA I20 was 2.62 (+/- 0.30) log10 CFU/mL in cages (n = 18) of daptomycin-treated rats, exceeding by > 2-fold (P < 0.01) the viable count reductions of 0.92 (+/- 0.23; n = 19) and 0.96 (+/- 0.24; n = 18) log10 CFU/mL in cages of oxacillin-treated and vancomycin-treated rats, respectively. Viable counts in cage fluids of untreated animals increased by 0.48 (+/- 0.24; n = 19) log10 CFU/mL. CONCLUSION: The improved efficacy of the twice-daily regimen of daptomycin (30 mg/kg) compared to oxacillin (200 mg/kg) or vancomycin (50 mg/kg) may result from optimisation of its pharmacokinetic and bactericidal properties in infected cage fluids.
Keywords AnimalsAnti-Bacterial Agents/ administration & dosage/adverseEffects/blood/pharmacokineticsDaptomycin/ administration & dosage/adverse effects/pharmacokinetics/ therapeuticUseForeign Bodies/ drug therapy/ microbiologyMicrobial Sensitivity TestsOxacillin/therapeutic useRatsStaphylococcal Infections/ drug therapyVancomycin/therapeutic use
PMID: 16608512
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SCHAAD, H. J. et al. Evaluation of high-dose daptomycin for therapy of experimental Staphylococcus aureus foreign body infection. In: BMC Infectious Diseases, 2006, vol. 6, p. 74. https://archive-ouverte.unige.ch/unige:9452

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Deposited on : 2010-07-12

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