토끼 심내막염 모델에서 Glycopeptide Intermediate Staphylococcus aureus에 대한 Arbekacin과 Teicoplanin 병용 요법의 효과
Efficacy of the Arbekacin and TeicoplaninCombination on Glycopeptide IntermediateStaphylococcus aureus in a Rabbit Model ofEndocarditis
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목 적 : 동물 모델을 이용하여 GISA에 의한 심내막염에서 teicoplain과 arbekacin 병용 요법의 치료 효과를 알아보고자 하였다. 재료 및 방법 : 토끼 심내막염 모델을 이용하여 GISA 에 의한 심내막염에서 teicoplanin과 arbekacin 병용 요법의 효과를 단독 요법의 효과와 비교하였다. GISA 균주는 Mu50 균주를 사용하였고, 기존 문헌과 동일한 방법으로 토끼를 이용하여 동맥판 심내막염 모델을 사용하였다. 항생제 치료는 균을 주사한지 20시간 이후에 시작하였다. Teicoplanin은 40 mg/kg를 1회 근육 주사한 후에 20 mg/kg의 용량을 12시간 마다 4일간 투여하였다. Arbekacin은 5 mg/kg를 12시간 마다 4일간 근육 주사하였다. 마지막 항균제 투여 20시간 이후에 토끼 대동맥판의 증식(vegetation)을 채취하였다. 항균제를 투여하지 않은 대조군, teicoplanin 단독 치료군, arbekacin 단독 치료군, teicoplanin과 arbekacin 병용 치료 군간의 증식의 무게(gram) 당 log10CFU의 차이를 비교하였다. 결 과 : Teicoplanin과 arbekacin 병용 치료군에서 teicoplanin 단독 치료군, 혹은 arbekacin 단독 치료군에 비해 증식의 무게(gram)당 log10CFU 값이 유의하게 낮았다(P <0.05). 결 론 : 동물 모델에서 GISA에 의한 심내막염에 대한 teicoplanin 과 arbekacin 병용 치료의 효과가 teicoplanin이나 arbekacin 단독 치료에 비해 우월하였다.
Abstract
Background : There have been no reports to evaluate the usefulness of combination therapy with glycopeptide and arbekacin in endocarditis by in vivo model. Materials and Methods : We investigated the efficacy of the arbekacin and teicoplanin combination on glycopeptide intermediate Staphylococcus aureus (GISA) in rabbit model of endocardits. GISA Mu50 strain was used for the experiment. The rabbit model of aortic valve endocarditis as described previously was used. Treatment was started 20h later inoculation with teicoplanin alone (at 20 mg/kg of body weight intramuscularly every 12 hours for 4 days after loading dose of 40 mg/kg of body weight intramuscularly), arbekacin alone (5 mg/kg of body weight intramuscularly every 12h for 4 days), or teicoplanin plus arbekacin. Results : The results of therapy for experimental endocarditis due to Mu50 showed that teicoplanin and arbekacin combination was more effective than the administration of both drugs alone in reducing the log10CFU/g of aortic vegetation (P＜0.05). Conclusion : The combination of teicoplanin and arbekacin was more effective against GISA (Mu50) than both drugs alone in vivo endocarditis model.
참고문헌 (17)
- Moore MR, "Vancomycn treatment failure associated with heterogeneous vancomycin-intermediate Staphylococcus aureus in a patient with endocarditis and?in the rabbit model of endocarditis", Antimicrob Agents Chemother, 47, pp.1262~1266 (2003)
- Pavie J, "Influence of reduced susceptibility to glycopeptides on activities of vancomycin and teicoplanin against Staphylococcus aureus in experimental endocarditis", Antimicrob Agents Chemother, 47, pp.2018~2021 (2003)
- Perry JD, "Glycopeptide tolerance in bacteria causing endocarditis", J Antmicrob Chemother, 44, pp.121~124 (1999)
- Hanaki H, "Combination effect of teicoplanin and various antibiotics against hetero-VRSA and VRSA", Kansenshogaku Zasshi, 73, pp.1048~1053 (1999)
- Lee JY, "Synergy of arbekacin- based combinations against vancomycin hetero- intermediate Staphylococcus aureus", J Korean Med Sci, 21, pp.188~192 (2006)
- National Committee for Clinical Laboratory Standards Institute, "Performance standards for antimicrobial disk susceptibility test, approved standards" (2003), CLSI
- Perlman BB, "Experimental endocarditis. II: Staphylococcal infection of the aortic valve following placement of a polyethylene catheter in the left side of the heart", Yale J Biol Med, 44, pp.206~213 (1971)
- Kak V, "Efficacy of ampicillin plus arbekacin in experimental rabbit endocarditis caused by an Enterococcus faecalis strain with high-level gentamicin resistance", Antimicrob Agents Chemother, 44, pp.2545~2546 (2000)
- Fantin B, "Influence of low-level resistance to vancomycin on efficacy of teicoplanin and vancomycin for treatment of experimental endocarditis due to Enterococcus faecium", Antimicrob Agents Chemother, 35, pp.1570~1575 (1991)
- Leclercq R, "Plasmid mediated resistance to vancomycin and teicoplanin in Enterococcus faecium", N Engl J Med, 319, pp.157~161 (1988)
- Hiramatsu K, "Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility", J Antimicrob Chemother, 40, pp.135~136 (1997)
- Hiramatsu K, "Vancomycin resistance staphylococci", Drug Resistance Updat, 1, pp.135~150 (1998)
- Levine DP, "Slow response to vancomycin or vancomycin plus rifampin in methicillin-resistant Staphylococcus aureus endocarditis", Ann Intern Med, 115, pp.674~680 (1991)
- Ubukata K, "Purification and characterization of aminoglycoside-modifying enzymes from Staphylococcus aureus and Staphylococcus epidermidis", Antimicrob Agents Chemother, 25, pp.754~759 (1984)
- Kondo S, "Synthesis of 1-n-{(S)-4-amino-2-hydroxybutytyl)}-kanamycin B and 3'-,4'-dideoxykanamycin B active against kanamycin resistant bacteria", J Antibiot, 26, pp.412~415 (1973)
- Mandell GL, "Principles and Practice of Infectious Diseases", pp.994~ (2005), Elsevier
- Gilbert DN, "Failure of treatment with teicoplanin at 6 milligrams", kilogram, Antimicrob Agents Chemother, pp.1991, 35[DOI]