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JAC Advance Access originally published online on March 23, 2006
Journal of Antimicrobial Chemotherapy 2006 57(6):1110-1115; doi:10.1093/jac/dkl098
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

In vitro evaluation of the antibiotic lock technique (ALT) for the treatment of catheter-related infections caused by staphylococci

Ji-Young Lee1,{dagger}, Kwan Soo Ko1,{dagger}, Kyong Ran Peck2,*, Won Sup Oh2 and Jae-Hoon Song1,2

1 Asian-Pacific Research Foundation for Infectious Diseases (ARFID) Seoul, Korea 2 Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine 50 Il-won dong, Kangnam-ku, Seoul 135-710, Korea

Received 8 January 2006; returned 16 February 2006; revised 2 March 2006; accepted 2 March 2006


*Corresponding author. Tel: +82-2-3410-0322; Fax: +82-2-3410-0041; E-mail: krpeck{at}smc.samsung.co.kr

Objectives: To investigate appropriate antimicrobial agents, the optimal concentration and treatment duration for the antibiotic lock technique (ALT) to treat catheter-related infections caused by Staphylococcus epidermidis and Staphylococcus aureus.

Methods: We evaluated the bacterial killing activity of vancomycin, teicoplanin, ciprofloxacin, rifampicin, cefazolin, gentamicin, nafcillin and erythromycin against biofilms formed by two strains of S. aureus and two strains of S. epidermidis. The effectiveness of the antibiotic lock was assayed after exposure to antibiotics (1, 5 and 10 mg/mL) for 1, 3, 5, 7, 10 or 14 days using an in vitro model of biofilms on polyurethane film.

Results: The biofilms were completely sterile after exposure to vancomycin (5 mg/mL) for 5 days and teicoplanin (5 and 10 mg/mL) for 7 days. Ciprofloxacin and rifampicin (both 5 mg/mL) achieved eradication of the biofilms of both staphylococcal species more rapidly than vancomycin or teicoplanin. Significant biofilm eradication was not achieved with cefazolin, nafcillin, gentamicin and erythromycin at any of the time exposures examined.

Conclusions: The data suggest that 5 mg/mL vancomycin, ciprofloxacin or rifampicin can eradicate S. epidermidis and S. aureus biofilms within 5 days. These findings warrant prospective clinical trials for the evaluation of the clinical efficacy of ALT for less than 10 days.

Keywords: Staphylococcus epidermidis , Staphylococcus aureus , biofilms , ciprofloxacin , rifampicin


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