Journal of Antimicrobial Chemotherapy (2001) 47, 623-629
© 2001 The British Society for Antimicrobial Chemotherapy
Comparative study of treatment with penicillin, ceftriaxone, trovafloxacin, quinupristin–dalfopristin and vancomycin in experimental endocarditis due to penicillin- and ceftriaxone-resistant Streptococcus pneumoniae
University Hospital ‘Virgen de la Arrixaca’, Murcia School of Medicine, Murcia; Cardiology and Microbiology Departments, Carretera del Palmar s/n, Murcia, Spain
The efficacy of different antibiotics was compared in an experimental model of aortic valve endocarditis in rabbits, using a serotype 19 strain of Streptococcus pneumoniae resistant to penicillin (MIC 12 mg/L) and ceftriaxone (MIC 12 mg/L). The results were compared with those of a control group, which received no treatment. One hundred and nineteen animals were treated with one of the following antibiotic regimens: im procaine penicillin G at a dosage of 300000 U/kg weight/12 h (16 animals); iv trovafloxacin, 13.3 mg/kg/12 h (31 animals); iv ceftriaxone, 75 mg/kg/24 h (21 animals); iv vancomycin, 20 mg/kg/12 h (15 animals) and im quinupristin–dalfopristin, 30 mg/kg/8 h (20 animals). All the antibiotics used in this study proved to be efficient in reducing numbers of S. pneumoniae and in increasing the percentage of aortic vegetations that were rendered sterile compared with the control group. Penicillin at the dosage used in our study was capable of achieving serum concentrations two or three times greater than the MIC, thus demonstrating its effectiveness as an antibiotic for this endocarditis model. No significant difference was observed between the effects of vancomycin, quinupristin–dalfopristin and penicillin. Vancomycin proved to be more efficient than trovofloxacin in reducing the bacterial load and increasing the numbers sterilized. There was also a tendency for this antibiotic to be more effective than ceftriaxone in reducing the bac-terial load of the vegetations. There was a statistically significant correlation between the weight of the vegetations and their bacterial load. In the light of these results, vancomycin and quinupristin–dalfopristin may be considered suitable alternatives to penicillin for the treat-ment of penicillin-resistant S. pneumoniae endocarditis.
* Correspondence address. Portillo de San Antonio 8, 5D, 30005 Murcia, Spain. Tel/Fax: +34-968-283679; E-mail: mvaldes{at}huva.es