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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new, investigational, parenteral form of sparfloxacin was compared with ceftriaxone in the treatment of experimental endocarditis caused by either of three penicillin-susceptible streptococci or one penicillin-resistant streptococcus. Both drugs have prolonged half-lives in serum, allowing single daily administration to humans. Sparfloxacin had relatively low MICs (0.25 to 0.5 mg/liter) for all four organisms and was also greater than or equal to eight times more effective than the other quinolones against 21 additional streptococcal isolates recovered from patients with bacteremia. Ceftriaxone MICs were 0.032 to 0.064 mg/liter for the penicillin-susceptible strains and 2 mg/liter for the resistant isolate. Both antibiotics resulted in moderate bacterial killing in vitro. Rats with catheter-induced aortic vegetations were inoculated with 10(7) CFU of the test organisms. Antibiotic treatment was started 48 h later and lasted either 3 or 5 days. The drugs were injected at doses which mimicked the kinetics in human serum produced by one intravenous injection of 400 mg of sparfloxacin (i.e., the daily dose expected to be given to human adults) and 2 g of ceftriaxone. Both antibiotics significantly decreased the bacterial densities in the vegetations. However, sparfloxacin was slower than ceftriaxone in its ability to eradicate valvular infection caused by penicillin-susceptible bacteria. While this difference was quite marked after 3 days of therapy, it tended to vanish when treatment was prolonged to 5 days. In contrast, sparfloxacin was very effective against the penicillin-resistant isolate, an organism against which ceftriaxone therapy failed in vivo. No sparfloxacin-resistant mutant was selected during therapy. Thus, in the present experimental setting, this new, investigational, parenteral form of sparfloxacin was effective against severe infections caused by both penicillin-susceptible and penicillin-resistant streptococci.
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PMID:Parenteral sparfloxacin compared with ceftriaxone in treatment of experimental endocarditis due to penicillin-susceptible and -resistant streptococci. 769 48

Sparfloxacin and clinafloxacin alone and in combination with gentamicin, were evaluated for the treatment of experimental endocarditis in rabbits caused by ampicillin-resistant enterococci. Clinafloxacin was tested against Enterococcus faecalis strain WH245, a beta-lactamase producer lacking high-level gentamicin resistance (MIC 12.5 mg/L). Sparfloxacin was tested against Enterococcus faecium strain SF2149 a non-producer of beta-lactamase (ampicillin MIC 400 mg/L, gentamicin MIC 12.5 mg/L). For strain WH245, clinafloxacin alone significantly reduced enterococcal counts in vegetations (7.7 log10 cfu/g) and for strain SF2149, sparfloxacin significantly reduced counts (7.0 log10 cfu/g) compared with untreated controls (WH245, 8.8 log10 cfu/g and SF2149, 9.3 log10 cfu) or treatment with ampicillin plus gentamicin (WH245, 9.7 log10 cfu/g). The addition of gentamicin resulted in no further reduction of bacterial counts in vegetations but resulted in an increase in sterilization of blood for strain SF2149. These results suggest that sparfloxacin and clinafloxacin and may prove useful in the therapy of infections due to ampicillin-resistant enterococci.
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PMID:Sparfloxacin and clinafloxacin alone or in combination with gentamicin for therapy of experimental ampicillin-resistant enterococcal endocarditis in rabbits. 812 36

Sparfloxacin, a new difluorinated quinolone antibiotic, was employed in the treatment of catheter-induced endocarditis in rabbits infected with a methicillin-resistant strain of Staphylococcus aureus (MRSA). Animals (n = 12) in the study group received sparfloxacin, 25 mg/kg body weight every 12 h intravenously. Comparison groups were untreated controls (n = 9) and animals injected with vancomycin (n = 13) at the same dosage. MICs and MBCs of the test organism were both 1.56 mg/l for vancomycin and 0.15/0.30 mg/l for sparfloxacin. Antibiotic treatments started 24 h after bacterial challenge and lasted 4 days until sacrifice. In comparison with no treatment, both sparfloxacin and vancomycin significantly reduced the bacterial counts in aortic vegetations, while no significant difference was found between the two antibiotics. Combination of the two antibiotics, tried in a smaller group of rabbits (n = 3) showed no advantages over either single-drug therapy. Our results suggest that sparfloxacin is a potentially useful agent, at least in the rabbit model, for treating MRSA endocardial infections.
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PMID:Sparfloxacin therapy for experimental endocarditis caused by methicillin-resistant Staphylococcus aureus. 869 88

Animal models are commonly used to determine the efficacy of various antimicrobial agents for treatment of bacterial endocarditis. Previously we have utilized an in vitro infection model, which incorporates simulated endocardial vegetations (SEVs) to evaluate the pharmacodynamics of various antibiotics. In the present study, we compared four experimental rabbit endocarditis protocols to an in vitro infection model in an effort to determine if these models are comparable. We have evaluated the activity of clinafloxacin, trovafloxacin, sparfloxacin, and ciprofloxacin in rabbit models against Staphylococcus aureus and Enterococcus spp. In vitro models were performed simulating the antibiotic pharmacokinetics obtained in the in vivo studies. Models were dosed the same as rabbit models, and SEVs were evaluated at the same time the rabbit vegetations were examined. Clinafloxacin and trovafloxacin were evaluated against methicillin-susceptible (MSSA1199) and -resistant (MRSA494) strains of S. aureus. Ciprofloxacin was studied against MSSA1199 and MSSA487. Sparfloxacin and clinafloxacin were evaluated against Enterococcus faecium SF2149 and Enterococcus faecalis WH245, respectively. We found that reductions in SEV bacterial density obtained in the in vitro model were similar to those obtained in rabbit vegetations, indicating that the SEV model may be a valuable tool for assessing antibiotic potential in the treatment of bacterial endocarditis.
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PMID:Comparison of a rabbit model of bacterial endocarditis and an in vitro infection model with simulated endocardial vegetations. 1085 55