Efficacy of levofloxacin in the treatment of experimental endocarditis caused by viridans group streptococci.

Details

Ressource 1Download: serval:BIB_9F748FCEDF72.P001 (100.40 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_9F748FCEDF72
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Efficacy of levofloxacin in the treatment of experimental endocarditis caused by viridans group streptococci.
Journal
Journal of Antimicrobial Chemotherapy
Author(s)
Entenza J.M., Caldelari I., Glauser M.P., Moreillon P.
ISSN
0305-7453 (Print)
ISSN-L
0305-7453
Publication state
Published
Issued date
1999
Volume
44
Number
6
Pages
775-786
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Levofloxacin was investigated against viridans group streptococci in vitro and in rats with experimental aortic endocarditis. The MIC(90)s of levofloxacin and ciprofloxacin for 20 independent isolates of such bacteria were 1 and 8 mg/L, respectively. Rats were infected with two types of organism: either fully susceptible to levofloxacin MIC < or = 0.5 mg/L) or borderline susceptible (MIC 1-2 mg/L). Fully levofloxacin-susceptible bacteria comprised one penicillin-susceptible (MIC 0.004 mg/L) Streptococcus gordonii, and one penicillin-tolerant as well as one intermediate penicillin-resistant (MIC 0.125 mg/L) isogenic strains. Borderline levofloxacin-susceptible bacteria comprised one penicillin-susceptible Streptococcus sanguis and one highly penicillin-resistant Streptococcus mitis (MIC 2 mg/L). Rats were treated for 5 days with drug dosages simulating the following treatments in humans: (i) levofloxacin 500 mg orally once a day (q24 h), (ii) levofloxacin 500 mg orally twice a day (q12 h), (iii) levofloxacin 1 g orally q24 h, (iv) ciprofloxacin 750 mg orally q12 h, and (v) ceftriaxone 2 g iv q24 h. Levofloxacin was equivalent or superior to ceftriaxone, and was successful in treating experimental endocarditis irrespective of penicillin resistance. Nevertheless, standard levofloxacin treatment equivalent to 500 mg q24 h in human was less effective than twice daily 500 mg or once daily 1 g doses against borderline-susceptible organisms. Ciprofloxacin, used as a negative control, was ineffective and selected for resistant isolates. This underlines the importance of MIC determinations when treating severe streptococcal infection with quinolones. In the case of borderline-susceptible pathogens, total daily doses of 1 g of levofloxacin should be considered.
Keywords
Animals, Anti-Infective Agents/pharmacokinetics, Anti-Infective Agents/pharmacology, Catheterization, Ceftriaxone/pharmacokinetics, Ceftriaxone/pharmacology, Ciprofloxacin/pharmacokinetics, Ciprofloxacin/pharmacology, Endocarditis, Bacterial/drug therapy, Endocarditis, Bacterial/microbiology, Microbial Sensitivity Tests, Ofloxacin/pharmacokinetics, Ofloxacin/pharmacology, Penicillin Resistance, Rats, Streptococcal Infections/drug therapy, Streptococcal Infections/microbiology, Streptococcus/drug effects, Streptococcus/growth & development, Streptococcus sanguis/drug effects, Streptococcus sanguis/growth & development, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
24/01/2008 13:45
Last modification date
25/09/2019 6:10
Usage data