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Published on: March 14, 2019
Vancomycin versus linezolid in the treatment of methicillin-resistant Staphylococcus aureus meningitis in an
Sebnem Calik1, Tuncer Turhan, Taskin Yurtseven
1Department of Infectious Diseases and Clinical Microbiology, Urla State Hospital, Izmir, Turkey. sebnemozkoren@yahoo.com
Background:
The aim of this study was to compare the antibacterial efficacy of vancomycin and linezolid in a rabbit model of methicillin-resistant Staphylococcus aureus (MRSA) meningitis.
Material/Methods:
Meningitis was induced by intracisternal inoculation of ATCC 43300 strain. After 16 h incubation time and development of meningitis, the vancomycin group received vancomycin 20 mg/kg every 12 h. The linezolid-10 and linezolid-20 groups received linezolid in 10 and 20 mg/kg dosages every 12 h, respectively. The control group did not receive any antibiotics. Cerebrospinal fluid bacterial counts were measured at the end of 16-h incubation time and at the end of 24-h treatment.
Results:
Bacterial counts were similar in all groups at 16 h. At the end of treatment the decrease in bacterial counts in the vancomycin group was approximately 2 logs higher than the linezolid-20 group (p>0.05) and approximately 4 logs higher than in the linezolid-10 group (p: 0.037) (Vancomycin group: -2.860 ± 4.495 versus Linezolid-20: -0.724 ± 4.360, versus Linezolid-10: 1.39 ± 3.37). Full or partial bacteriological response was higher in vancomycin versus linezolid-10 (p: 0.01), but not vancomycin versus linezolid-20 or linezolid-10 versus-linezolid-20 groups.
Conclusions:
Our results suggest that linezolid is not statistically inferior to vancomycin in the treatment of MRSA meningitis in an experimental rabbit model in 20 mg/kg q12 h dosage; however, it is inferior in 10 mg/kg q12 h dosage. Additional data should gathered to confirm these findings in advance of clinical trials to assess efficacy in humans.
Insights
In a rabbit model of methicillin-resistant Staphylococcus aureus (MRSA) meningitis, vancomycin showed superior bacterial reduction compared to linezolid at 10 mg/kg. However, linezolid at 20 mg/kg was not statistically inferior to vancomycin.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Bacterial meningitis remains a significant global health concern.
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a particular challenge due to its resistance to common antibiotics.
- Effective treatment strategies for MRSA meningitis are crucial.
Purpose of the Study:
- To compare the antibacterial efficacy of vancomycin and linezolid.
- To evaluate these antibiotics in a rabbit model of MRSA meningitis.
- To determine optimal dosing for linezolid against MRSA meningitis.
Main Methods:
- MRSA meningitis was induced in rabbits via intracisternal inoculation.
- Animals received vancomycin (20 mg/kg q12h) or linezolid (10 or 20 mg/kg q12h).
- Cerebrospinal fluid bacterial counts were assessed before and after treatment.
Main Results:
- Bacterial counts were comparable across all groups initially.
- Vancomycin demonstrated a greater reduction in bacterial counts than linezolid at both 10 mg/kg and 20 mg/kg.
- A higher rate of bacteriological response was observed with vancomycin compared to linezolid at 10 mg/kg.
Conclusions:
- Linezolid at 20 mg/kg q12h was not statistically inferior to vancomycin for MRSA meningitis in this rabbit model.
- Linezolid at 10 mg/kg q12h was statistically inferior to vancomycin.
- Further research is warranted to confirm these findings before human clinical trials.
