Single-dose oral amoxicillin or linezolid for prophylaxis of experimental endocarditis due to vancomycin-susceptible and vancomycin-resistant Enterococcus faecalis.

Details

Serval ID
serval:BIB_5CEECF3D08AE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Single-dose oral amoxicillin or linezolid for prophylaxis of experimental endocarditis due to vancomycin-susceptible and vancomycin-resistant Enterococcus faecalis.
Journal
Antimicrobial Agents and Chemotherapy
Author(s)
Moreillon P., Wilson W.R., Leclercq R., Entenza J.M.
ISSN
0066-4804[print], 0066-4804[linking]
Publication state
Published
Issued date
2007
Volume
51
Number
5
Pages
1661-1665
Language
english
Abstract
Endocarditis prophylaxis following genitourinary or gastrointestinal procedures targets Enterococcus faecalis. Prophylaxis recommendations advocate oral amoxicillin (2 g in the United States and 3 g in the United Kingdom) in moderate-risk patients and intravenous amoxicillin (2 g) or vancomycin (1 g) plus gentamicin in high-risk patients. While ampicillin-resistant (or amoxicillin-resistant) E. faecalis is still rare, there is a concern that these regimens might fail against vancomycin-resistant and/or aminoglycoside-resistant isolates. The present study tested oral linezolid as an alternative. Rats with catheter-induced aortic vegetations were given prophylaxis simulating human pharmacokinetics of oral amoxicillin (2- to 3-g single dose), oral linezolid (600 mg, single or multiple oral doses every 12 h), or intravenous vancomycin (1-g single dose). Rats were then inoculated with the minimum inoculum infecting 90% of the animals (90% infective dose [ID(90)]) or with 10 times the ID(90) of the vancomycin-susceptible E. faecalis strain JH2-2 or the vancomycin-resistant (VanA phenotype) E. faecalis strain UCN41. Amoxicillin was also tested with two additional vancomycin-susceptible E. faecalis strains, 309 and 1209. Animals were sacrificed 3 days later. All the tested bacteria were susceptible to amoxicillin and gentamicin. Single-dose amoxicillin provided 100% protection against all four isolates at both the ID(90) and 10 times the ID(90). In contrast, linezolid required up to four consecutive doses to provide full protection against the vancomycin-resistant isolate. Vancomycin protected only against the vancomycin-susceptible strain. The high efficacy of single-dose oral amoxicillin suggests that this regimen could be used for prophylaxis in both moderate-risk and high-risk patients without additional aminoglycosides. Linezolid appears to be less reliable, at least against the vancomycin-resistant strain.
Keywords
Acetamides/blood, Acetamides/therapeutic use, Administration, Oral, Amoxicillin/blood, Amoxicillin/therapeutic use, Animals, Anti-Bacterial Agents/therapeutic use, Antibiotic Prophylaxis, Endocarditis, Bacterial/prevention & control, Enterococcus faecalis/drug effects, Female, Microbial Sensitivity Tests, Oxazolidinones/blood, Oxazolidinones/therapeutic use, Rats, Rats, Wistar, Vancomycin Resistance
Pubmed
Web of science
Open Access
Yes
Create date
24/01/2008 14:45
Last modification date
20/08/2019 15:15
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