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Ciprofloxacin therapy of experimental endocarditis caused by methicillin-resistant Staphylococcus epidermidis
M S Rouse1, R M Wilcox, N K Henry
1Mayo Clinic and Foundation, Mayo Medical School, Rochester, Minnesota 55905.
Abstract:
Ciprofloxacin or rifampin was significantly (P less than 0.05) more effective than vancomycin or the combination of vancomycin plus gentamicin for the treatment of Staphylococcus epidermidis experimental endocarditis. There were no significant differences in efficacy among any of the combinations of antimicrobial agents that included ciprofloxacin or rifampin. One animal treated with rifampin alone and one treated with the combination of vancomycin, rifampin, and gentamicin were found to be infected with rifampin-resistant strains of S. epidermidis during therapy. Resistant subpopulations of S. epidermidis were not detected during therapy with any other antimicrobial agent used alone or in combination. Ciprofloxacin alone or in combination with rifampin was effective therapy against S. epidermidis experimental endocarditis.
Insights
Ciprofloxacin and rifampin showed superior efficacy over vancomycin for treating Staphylococcus epidermidis endocarditis. Combination therapies including ciprofloxacin or rifampin were also effective, with limited resistance development.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Staphylococcus epidermidis is a common cause of healthcare-associated infections, particularly endocarditis.
- Effective antimicrobial therapy is crucial for managing S. epidermidis endocarditis.
- Vancomycin is a standard treatment, but resistance and treatment failures necessitate exploring alternative agents.
Purpose of the Study:
- To compare the efficacy of ciprofloxacin and rifampin against vancomycin for experimental Staphylococcus epidermidis endocarditis.
- To evaluate combination antimicrobial therapies including ciprofloxacin and rifampin.
- To assess the development of antimicrobial resistance during treatment.
Main Methods:
- Experimental endocarditis model in animals.
- Treatment with ciprofloxacin, rifampin, vancomycin, gentamicin, and various combinations.
- Assessment of treatment efficacy and detection of resistant S. epidermidis strains.
Main Results:
- Ciprofloxacin and rifampin were significantly more effective than vancomycin or vancomycin plus gentamicin.
- No significant differences in efficacy were observed among regimens containing ciprofloxacin or rifampin.
- Rifampin resistance emerged in two animals; no other resistance was detected.
Conclusions:
- Ciprofloxacin, alone or with rifampin, represents an effective therapeutic option for S. epidermidis endocarditis.
- Rifampin-containing regimens should be used cautiously due to potential resistance development.
- Further research into optimal combination therapies and resistance monitoring is warranted.