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JAC Advance Access published online on October 4, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki363
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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 July 10, 2005
Revised September 1, 2005
Accepted September 13, 2005

Brief report

Successful moxifloxacin prophylaxis against experimental streptococcal aortic valve endocarditis

Vissaria Sakka 1, Lambrini Galani 1, Angelos Pefanis 2*, Dimitrios Iliopoulos 3, George Athanasopoulos 1, Ismini Donta 3, and Helen Giamarellou 1

1 4th Department of Internal Medicine, General Hospital ‘Attikon’, University of Athens, Medical School, Athens, Greece
2 3rd Department of Internal Medicine, General Hospital ‘Sotiria’, University of Athens, Medical School, 152 Mesogion Avenue 11527, Athens, Greece
3 Laboratory of Experimental Surgery and Surgical Research, General Hospital ‘Laikon’, University of Athens, Medical School, Athens, Greece; 2nd Department of Propedeutic Surgery, General Hospital ‘Laikon’, University of Athens, Medical School, Athens, Greece

* To whom correspondence should be addressed.
Angelos Pefanis, E-mail: apefan{at}med.uoa.gr


  Abstract

Objectives: Studies related to the prophylactic efficacy of fluoroquinolones against infective endocarditis are scarce. The aim of this study was to evaluate the efficacy of moxifloxacin, a quinolone active in vitro against Gram-positive cocci, in preventing streptococcal aortic valve endocarditis.

Methods: Non-bacterial thrombotic endocarditis of the aortic valve was induced by the insertion of a polyethylene catheter. Twenty-four hours later, rabbits were randomly assigned to a control group, and groups receiving either two doses of ampicillin (40 mg/kg, intravenously), 2 h apart, or a single dose of moxifloxacin (15 mg/kg, intravenously). Ampicillin and moxifloxacin were administered 0.5 and 1 h, respectively, prior to the intravenous inoculation of 107 cfu of Streptococcus oralis.

Results: Eighty-nine percent of the control animals developed infected vegetations. In rabbits challenged with this very high inoculum, moxifloxacin and ampicillin prevented endocarditis in 80% (P < 0.001 versus controls) and in 50% (P = 0.022 versus controls) of animals, respectively. The difference between ampicillin and moxifloxacin was not statistically significant (P = 0.128).

Conclusions: Moxifloxacin was at least as effective as ampicillin in preventing streptococcal endocarditis.

Keywords: Streptococcus oralis; fluoroquinolones; rabbits; ampicillin.
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