Efficacy of Telavancin Alone and in Combination with Ampicillin in a Rat Model of Enterococcus faecalis Endocarditis.

Abstract

We first assessed telavancin (TLV) pharmacokinetics in rats after a single subcutaneous dose of 35 mg/kg of body weight. The pharmacokinetic data were used to predict a TLV dose that simulates human exposure, and the efficacy of TLV was then evaluated using a TLV dose of 21 mg/kg every 12 h against Enterococcus faecalis OG1RF (TLV MIC of 0.06 μg/ml) in a rat endocarditis model with an indwelling catheter. Therapy was given for 3 days with TLV, daptomycin (DAP), or ampicillin (AMP) monotherapy and with combinations of TLV plus AMP, AMP plus gentamicin (GEN), and AMP plus ceftriaxone (CRO); rats were sacrificed 24 h after the last dose. Antibiotics were given to simulate clinically relevant concentrations or as used in other studies. TLV treatment resulted in a significant decrease in bacterial burden (CFU per gram) in vegetations from 6.0 log10 at time 0 to 3.1 log10 after 3 days of therapy. Bacterial burdens in vegetations were also significantly lower in the TLV-treated rats than in the AMP (P = 0.0009)- and AMP-plus-GEN (P = 0.035)-treated rats but were not significantly different from that of the AMP-plus-CRO-treated rats. Bacterial burdens from vegetations in TLV monotherapy and TLV-plus-AMP-and-DAP groups were similar to each other (P ≥ 0.05). Our data suggest that further study of TLV as a therapeutic alternative for deep-seated infections caused by vancomycin-susceptible E. faecalis is warranted.

• Authors: Truc T Tran, Vincent H Tam, Barbara E Murray, Cesar A Arias, Kavindra V Singh
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 61 Issue 6 (06 2017) ISSN: 1098-6596 [Electronic] United States
• PMID: 28320712 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 American Society for Microbiology.

Chemical References

• Aminoglycosides
• Anti-Bacterial Agents
• Cephalosporins
• Gentamicins
• Lipoglycopeptides
• Vancomycin
• Ceftriaxone
• Ampicillin
• Daptomycin
• telavancin

Topics

• Aminoglycosides (therapeutic use)
• Ampicillin
• Animals
• Anti-Bacterial Agents (therapeutic use)
• Ceftriaxone (therapeutic use)
• Cephalosporins (therapeutic use)
• Daptomycin (therapeutic use)
• Drug Therapy, Combination
• Endocarditis, Bacterial
• Enterococcus faecalis
• Gentamicins (therapeutic use)
• Lipoglycopeptides
• Male
• Microbial Sensitivity Tests
• Rats
• Rats, Sprague-Dawley
• Vancomycin (therapeutic use)