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Comparison Of Different β-Lactam-Glycopeptide-Gentamicin Combinations For An Experimental Endocarditis Caused By A Highly β-Lactam-Resistant And Highly Glycopeptide-Resistant Isolate Of Enterococcus faecium
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Comparison Of Different β-Lactam-Glycopeptide-Gentamicin Combinations For An Experimental Endocarditis Caused By A Highly β-Lactam-Resistant And Highly Glycopeptide-Resistant Isolate Of Enterococcus faecium
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Comparison Of Different β-Lactam-Glycopeptide-Gentamicin Combinations For An Experimental Endocarditis Caused By A Highly β-Lactam-Resistant And Highly Glycopeptide-Resistant Isolate Of Enterococcus faecium
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Journal Article
Comparison Of Different β-Lactam-Glycopeptide-Gentamicin Combinations For An Experimental Endocarditis Caused By A Highly β-Lactam-Resistant And Highly Glycopeptide-Resistant Isolate Of Enterococcus faecium
1995
Overview
A synergistic bactericidal effect between penicillin, vancomycin, and gentamicin has been described against enterococci highly resistant to β-Iactams and glycopeptides. Since such a synergy was also observed in vitro between ceftriaxone, teicoplanin, and gentamicin against Enterococcus faecium 70/90, the efficacy of different combinations including penicillin or ceftriaxone, vancomycin or teicoplanin, and gentamicin was compared in vivo in experimental endocarditis. In vitro, all four triple combinations provided a bactericidal effect. In rabbits, after a 5-day treatment, the ceftriaxone-vancomycin-gentamicin combination was the most effective, both in reducing the total bacterial titers and in eradicating the subpopulation resistant to the synergy. Compared with the 5-day regimen, 10- and 20-day regimens of ceftriaxone-vancomycin-gentamicin, each followed by a 3-day antibiotic-free period, increased the number of sterilized animals but failed to avoid the emergence of resistant bacteria, which occurred in 10%-20% of animals.
Publisher
The University of Chicago Press,University of Chicago Press
Subject
/ Bacteria
/ Ceftriaxone - therapeutic use
/ Drug Therapy, Combination - pharmacology
/ Drug Therapy, Combination - therapeutic use
/ Endocarditis, Bacterial - drug therapy
/ Endocarditis, Bacterial - microbiology
/ Enterococcus faecium - drug effects
/ Female
/ Gentamicins - therapeutic use
/ Gram-Positive Bacterial Infections - drug therapy
/ Gram-Positive Bacterial Infections - microbiology
/ Penicillins - therapeutic use
/ Rabbits
/ Teicoplanin - therapeutic use
