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Antimicrobial Agents and Chemotherapy, July 1998, p. 1837-1841, Vol. 42, No. 7
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Efficacy of Trovafloxacin, a New Quinolone Antibiotic, in Experimental Staphylococcal Endocarditis Due to Oxacillin-Resistant Strains

Arnold S. Bayer,1,2,* Cong Li,1 and Michael Ing1,dagger

Division of Infectious Diseases and the St. John's Cardiovascular Research Center, Harbor-UCLA Medical Center, Torrance, California 90509,1 and the UCLA School of Medicine, Los Angeles, California 900242

Received 17 February 1998/Returned for modification 30 March 1998/Accepted 6 May 1998

Therapeutic options for severe infections caused by strains of oxacillin-resistant Staphylococcus aureus (ORSA) and coagulase-negative staphylococci (ORSE) are very limited. With the increasing resistance of such strains to aminoglycosides, rifampin, and currently available quinolone agents, as well as the recent documentation of increasing resistance of ORSA to vancomycin (VANCO), new treatment alternatives are imperative. The in vivo efficacy of trovafloxacin (TROVA), a new quinolone agent with excellent antistaphylococcal activity in vitro, against experimental endocarditis (IE) due to beta -lactamase-producing ORSA and ORSE strains (ORSA and ORSE IE) was evaluated. TROVA (25 mg/kg of body weight intravenously [i.v.] twice daily [b.i.d.]) was compared to VANCO (20 mg/kg i.v. b.i.d.) and two regimens of ampicillin-sulbactam (AMP-SUL; 200 mg/kg intramuscularly [i.m.] three times a day [t.i.d.] and 20 mg/kg i.m. b.i.d.), with all agents given for 3 or 6 days. AMP-SUL was included as a comparative treatment regimen because of its proven efficacy against experimental ORSA and ORSE IE. For both ORSA and ORSE IE, TROVA, AMP-SUL, and VANCO each reduced staphylococcal densities in vegetations compared to untreated controls (P < 0.01). For ORSA IE, TROVA was the most rapidly bactericidal agent---although not to a statistically significant degree---correlating with its superior bactericidal effect in vitro compared to those of VANCO and AMP-SUL.

* Corresponding author. Mailing address: Division of Infectious Diseases, Harbor-UCLA Medical Center, 1000 West Carson St., Bldg. RB2/Room 225, Torrance, CA 90509. Phone: (310) 222-6422. Fax: (310) 782-2016. E-mail: Bayer{at}HUMC.EDU.

dagger Present address: Division of Infectious Diseases, Pettis VA Medical Center, Loma Linda, CA 92357.

Antimicrobial Agents and Chemotherapy, July 1998, p. 1837-1841, Vol. 42, No. 7
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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