Efficacy of Telavancin in Comparison to Linezolid in a Porcine Model of Severe Methicillin-Resistant Staphylococcus aureus Pneumonia.

Abstract

Current guidelines recommend vancomycin and linezolid as first-line agents against methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia. Telavancin is a potential new therapeutic alternative, specifically in monomicrobial MRSA pneumonia. This study compared the efficacies of telavancin versus linezolid in a porcine model of severe MRSA pneumonia. In 18 mechanically ventilated pigs (32.11 ± 1.18 kg), 75 ml of 106 CFU/ml of MRSA was administered into each pulmonary lobe. After the onset of pneumonia, pigs were randomized into three groups: a control group, a group receiving 22.5 mg/kg of body weight every 24 h (q24h) of telavancin, and a group receiving 10 mg/kg q12h of linezolid intravenously. Tracheal aspirate and bronchoalveolar lavage (BAL) fluids were cultured every 24 h. After 48 h of treatment, tissue samples were collected from the ventral and dorsal sections of each lobe. Microbiological and histopathological analyses were performed. Lung tissue concentrations differed among the groups (P = 0.019), with the lowest MRSA lung burden in the telavancin group (P < 0.05 versus the control). MRSA was detected in 46.7%, 40.0%, and 21.7% of the lung tissue samples from the control, linezolid, and telavancin groups, respectively (P < 0.001). MRSA concentrations differed among the groups in tracheal aspirate fluid (P = 0.011) but not in BAL fluid. Furthermore, there was no increased risk of kidney injury during telavancin use. Thus, telavancin has higher bactericidal efficacy than linezolid during the first 48 h of treatment in a porcine model of severe MRSA pneumonia. However, studies are needed to confirm the benefits of telavancin in treating MRSA nosocomial pneumonia.

• Authors: D Battaglini, A Motos, G Li Bassi, H Yang, F Pagliara, M Yang, E Aguilera Xiol, A Meli, J Bobi, G Frigola, T Senussi, F Idone, C Travierso, C Chiurazzi, L Fernandez-Barat, M Rigol, J Ramirez, P Pelosi, D Chiumello, M Antonelli, D P Nicolau, J Bringue, A Artigas, L Guerrero, D Soy, A Torres
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 65 Issue 1 (12 16 2020) ISSN: 1098-6596 [Electronic] United States
• PMID: 33046500 (Publication Type: Journal Article, Randomized Controlled Trial, Veterinary, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 American Society for Microbiology.

Chemical References

• Aminoglycosides
• Anti-Bacterial Agents
• Lipoglycopeptides
• Linezolid
• telavancin

Topics

• Aminoglycosides
• Animals
• Anti-Bacterial Agents (therapeutic use)
• Linezolid (therapeutic use)
• Lipoglycopeptides
• Methicillin-Resistant Staphylococcus aureus
• Pneumonia, Staphylococcal (drug therapy)
• Swine