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Journal of Antimicrobial Chemotherapy (1996) 37, 323-329
© 1996 The British Society for Antimicrobial Chemotherapy

research-article

Treatment of experimental endocarditis caused by multidrug resistant Enterococcus faecium with ramoplanin and penicillin

David Landmana, John M. Qualea, Sibte Burneya, Barry Kreiswirthb and Barbara M. Willeyc

aDepartment of Medicine, Department of Veterans Affairs Medical Center Brooklyn, New York bPublic Health Research Institute New York, USA cDepartment of Microbiology, Mount Sinai and Princess Margaret Hospitals Toronto, Ontario, Canada

Received 22 March 1995; returned 11 July 1995; accepted 30 August 1995

Antibiotic resistant strains of enterococci are being isolated with increasing frequency. Effective treatment of infections caused by Enterococcus faecium resistant to ampicillin, vancomycin and aminoglycosides has not been established. We studied the activity of ramoplanin, a new lipoglycopeptide antibiotic, against two strains of multidrug resistant E. faecium. In time kill studies, ramoplanin was bactericidal against both strains, but not in the presence of 50% serum. The combination of ramoplanin and penicillin was bactericidal even in the presence of serum. In rabbits with experimental endocarditis neither penicillin nor ramoplanin significantly reduced vegetation colony counts when given alone, although ramoplanin significantly reduced spleen and kidney bacterial counts of both strains. The combination of ramoplanin plus penicillin resulted in a significant reduction of vegetation bacterial counts (- 3.2 and - 3.7 log10cfu/g for strains VA3 and MMC3, respectively, P<0.01). All spleen cultures and 9 out of 10 kidney cultures from each strain were sterile following combination therapy. While ramoplanin will not be available for parenteral therapy, further research into the development of other lipoglycopeptide antibiotics is warranted.


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