This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lewis, R. E.
Right arrow Articles by Jones, R. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lewis, R. E.
Right arrow Articles by Jones, R. N.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, August 1999, p. 2005-2009, Vol. 43, No. 8
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Evaluation of Low-Dose, Extended-Interval Clindamycin Regimens against Staphylococcus aureus and Streptococcus pneumoniae Using a Dynamic In Vitro Model of Infection

Russell E. Lewis,1 Michael E. Klepser,1,* Erika J. Ernst,1 Brian C. Lund,1 Douglas J. Biedenbach,2 and Ronald N. Jones2

University of Iowa Colleges of Pharmacy1 and Medicine,2 Iowa City, Iowa

Received 12 November 1998/Returned for modification 14 March 1999/Accepted 20 May 1999

We have previously described the activity of low-dose clindamycin in extended-interval dosing regimens by determination of bactericidal titer in serum. In this study, we used a one-compartment in vitro dynamic infection model to compare the pharmacodynamics of clindamycin in three intravenous-dosing regimens (600 mg every 8 h [q8h], 300 mg q8h, and 300 mg q12h) against three clinical isolates of Staphylococcus aureus and two clinical isolates of Streptococcus pneumoniae. Test organisms were added to the central compartment of the model to yield a starting inoculum of 106 CFU/ml. Clindamycin was injected as a bolus into the central compartment at appropriate times over 48 h to simulate the q8h or q12h dosing regimens. Drug-free culture medium was then pumped through the system to mimic a half-life of 2.4 h. At predetermined time points during the experiment, samples were removed from the central compartments for colony count determination and drug concentration analysis. The rates of killing did not significantly differ among the three clindamycin dosing regimens against either S. aureus or S. pneumoniae (P = 0.88 or 0.998, respectively). Likewise, no significant differences in activities were detected among the three regimens against staphylococci (P = 0.677 and 0.667) or pneumococci (P = 0.88 and 0.99). Against an S. aureus isolate exhibiting inducible macrolide-lincosamide-streptogramin B resistance, none of the three clindamycin regimens prevented regrowth of the resistance phenotype in the model. In this model, clindamycin administered at a low dose in an extended-interval regimen (300 mg q12h) exhibited antibacterial activity equivalent to that of the 300- or 600-mg-q8h regimen.


* Corresponding author. Mailing address: University of Iowa, College of Pharmacy, 412 S. Pharmacy Building, Iowa City, IA 52242-1112. Phone: (319) 335-8861. Fax: (319) 353-5646. E-mail: michael-klepser{at}uiowa.edu.


Antimicrobial Agents and Chemotherapy, August 1999, p. 2005-2009, Vol. 43, No. 8
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.



This article has been cited by other articles:

  • LaPlante, K. L., Leonard, S. N., Andes, D. R., Craig, W. A., Rybak, M. J. (2008). Activities of Clindamycin, Daptomycin, Doxycycline, Linezolid, Trimethoprim-Sulfamethoxazole, and Vancomycin against Community-Associated Methicillin-Resistant Staphylococcus aureus with Inducible Clindamycin Resistance in Murine Thigh Infection and In Vitro Pharmacodynamic Models. Antimicrob. Agents Chemother. 52: 2156-2162 [Abstract] [Full Text]