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Antimicrobial Agents and Chemotherapy, August 1999, p. 2005-2009, Vol. 43, No. 8
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.
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
*
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.
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