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AUC/MIC Pharmacodynamic Target Is Not a Good Predictor of Vancomycin Efficacy in Methicillin-Resistant Staphylococcus aureus Experimental Endocarditis.

Abstract
The aim of this in vivo study was to compare the efficacy of vancomycin at standard doses (VAN-SD) to that of VAN at adjusted doses (VAN-AD) in achieving a VAN area under the curve/MIC ratio (AUC/MIC) of ≥400 against three methicillin-resistant Staphylococcus aureus (MRSA) strains with different microdilution VAN MICs in an experimental endocarditis model. The valve vegetation bacterial counts after 48 h of VAN therapy were compared, and no differences were observed between the two treatment groups for any of the three strains tested. Overall, for VAN-SD and VAN-AD, the rates of sterile vegetations were 15/45 (33.3%) and 21/49 (42.8%) (P = 0.343), while the medians (interquartile ranges [IQRs]) for log10 CFU/g of vegetation were 2 (0 to 6.9) and 2 (0 to 4.5) (P = 0.384), respectively. In conclusion, this VAN AUC/MIC pharmacodynamic target was not a good predictor of vancomycin efficacy in MRSA experimental endocarditis.
AuthorsXimena Castañeda, Cristina García-de-la-Mària, Oriol Gasch, Juan M Pericas, Yolanda Armero, Dolors Soy, Javier García-González, Carlos Falces, Salvador Ninot, Manel Almela, Juan Ambrosioni, Eduardo Quintana, Barbara Vidal, David Fuster, Jaume Llopis, Sara Soto, Asuncion Moreno, Francesc Marco, Jose M Miró, Hospital Clinic Endocarditis Study Group
JournalAntimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 61 Issue 6 (06 2017) ISSN: 1098-6596 [Electronic] United States
PMID28373187 (Publication Type: Journal Article)
CopyrightCopyright © 2017 American Society for Microbiology.
Chemical References
  • Anti-Bacterial Agents
  • Vancomycin
Topics
  • Animals
  • Anti-Bacterial Agents (therapeutic use)
  • Economics, Pharmaceutical
  • Endocarditis (drug therapy)
  • Endocarditis, Bacterial (drug therapy)
  • Humans
  • Methicillin-Resistant Staphylococcus aureus (drug effects, pathogenicity)
  • Microbial Sensitivity Tests
  • Rabbits
  • Vancomycin (therapeutic use)

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