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JAC Advance Access published online on September 8, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki304
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© The Author 2005. 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
Received April 19, 2005
Revised August 2, 2005
Accepted August 4, 2005

Original article

Efficacy of {beta}-lactams against experimental pneumococcal endocarditis caused by strains with different susceptibilities to penicillin

Cristina Pichardo 1*, Fernando Docobo-Pérez 1, Maria E. Pachón-Ibáñez 1, Manuel E. Jiménez-Mejías 1, Andrés García-Curiel 2, F. Javier Caballero-Granado 3, Ignacio Moreno-Maqueda 3, and Jerónimo Pachón 1

1 Infectious Diseases Service, Virgen del Rocío University Hospitals, Sevilla, Spain
2 Microbiology Service, Virgen del Rocío University Hospitals, Sevilla, Spain
3 Infectious Diseases Service, Virgen del Rocío University Hospitals, Sevilla, Spain; Present address. Infectious Diseases Section, Internal Medicine Service, Punta de Europa Hospital, Algeciras (Cádiz), Spain

* To whom correspondence should be addressed.
Cristina Pichardo, E-mail: cristina.pichardo.exts{at}juntadeandalucia.es


  Abstract

Objectives: To compare the in vitro and in vivo activity of penicillin, cefotaxime and ceftriaxone, using three strains of Streptococcus pneumoniae with different susceptibilities to penicillin (MICs of 0.015, 0.25 and 2 mg/L, respectively).

Methods: Time-kill curves and an experimental model of endocarditis in rabbits.

Results: Penicillin was efficacious in clearing bacteria from vegetations and blood irrespective of whether infections were caused by penicillin-susceptible or penicillin-resistant strains (P < 0.01 with respect to control groups). The same efficacy was shown with cefotaxime and ceftriaxone. Comparing the results of the in vivo model with those obtained in time-kill curves, penicillin showed the best results.

Conclusions: These results confirm that penicillin is efficacious in the treatment of pneumococcal infections, including those produced by strains with MICs ≤ 2 mg/L (with the exception of pneumococcal meningitis). These results also suggest that the breakpoints to define susceptibility and resistance of S. pneumoniae to penicillin must be reviewed, as has been done with amoxicillin and third-generation cephalosporins.

Keywords: Streptococcus pneumoniae; antimicrobial resistance; antimicrobial therapy.
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