Successful treatment with moxifloxacin of experimental aortic valve endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA)

Int J Antimicrob Agents. 2009 Jan;33(1):65-9. doi: 10.1016/j.ijantimicag.2008.07.021. Epub 2008 Sep 24.

Abstract

Moxifloxacin (MXF) is an 8-methoxyquinolone with high activity against Gram-positive bacteria. In an experimental model of aortic valve endocarditis (EAVE), the efficacy of MXF was evaluated against a strain of methicillin-resistant Staphylococcus aureus (MRSA). Rabbits with catheter-induced aortic valve vegetations were randomly assigned to a control group or to groups receiving MXF 20 mg/kg intravenous (i.v.) twice a day (bid) or vancomycin (VAN) 30 mg/kg i.v. bid for a total of eight doses (4 days). Rabbits were sacrificed 15 h after the last dose of antibiotics. In another group, treatment with MXF was extended to 5 days and rabbits were sacrificed 5 days after the last dose (10th dose) of MXF in order to detect possible relapses of endocarditis after the end of treatment (test-of-cure (TOC) study). Both MXF and VAN significantly reduced the bacterial load in vegetations (P < 0.001 vs. controls). All animals in the MXF-TOC group had sterile vegetations. MXF given at a dose of 20 mg/kg i.v. bid for 4 days was equally effective as VAN in the treatment of EAVE due to MRSA. When treatment with MXF was extended to 5 days, the cure rate reached 100% and no relapses of endocarditis were observed.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / therapeutic use*
  • Aortic Valve / microbiology*
  • Aortic Valve / pathology
  • Aza Compounds / administration & dosage
  • Aza Compounds / pharmacokinetics
  • Aza Compounds / therapeutic use*
  • Disease Models, Animal
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / mortality
  • Female
  • Fluoroquinolones
  • Heart Valve Diseases / drug therapy*
  • Heart Valve Diseases / microbiology
  • Heart Valve Diseases / mortality
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Microbial Sensitivity Tests
  • Moxifloxacin
  • Quinolines / administration & dosage
  • Quinolines / pharmacokinetics
  • Quinolines / therapeutic use*
  • Rabbits
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / mortality
  • Treatment Outcome
  • Vancomycin / administration & dosage
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Vancomycin
  • Moxifloxacin