Efficacy of Amikacin, Ofloxacin, Pefloxacin, Ciprofloxacin, Enoxacin and Fleroxacin in Experimental Left-Sided <i>Pseudomonas aeruginosa</i> Endocarditis

Abstract

The efficacies of amikacin, ofloxacin, pefloxacin, ciprofloxacin, enoxacin and fleroxacin, each as monotherapy, were evaluated in a rabbit model of induced left-sided Pseudomonas aeruginosa endocarditis. Therapy started 48 h after infection and lasted 5 days. All agents were given intramuscularly; amikacin at 7 mg/kg/12 h, and each quinolone at 35 mg/kg/12 h. All animals survived except for 1 of the group that received amikacin, and 2 of the untreated control group. No sterile vegetations were found in the untreated group and the group of fleroxacin, while 3 animals from the amikacin, ofloxacin, and enoxacin groups, and 2 from the ciprofloxacin and pefloxacin groups had sterile vegetations. All agents used significantly reduced the number of CFU per gram of vegetation versus untreated controls. Enoxacin and ciprofloxacin were equipotent and more effective than pefloxacin, ofloxacin and amikacin. Fleroxacin had a weaker activity.

Synergistic interaction between phage therapy and antibiotics clears Pseudomonas aeruginosa infection in endocarditis and reduces virulence

“…This remarkable result has no precedent in antimicrobial therapy of EE with virtually any drug or pathogen, especially not with P. aeruginosa [31–33]. …”

Left Atrial Myxoma Prolapsing into the Left Ventricle

“…Enoxacin and ciprofloxacin were equipotent and more effective in comparison with pefloxacin, ofloxacin and amikacin, whilst fleroxacin presented a weaker activity [10].…”

“…Since Pseudomonas aeruginosa may cause infectious endocarditis, monotherapy with amikacin, ofloxacin, pefloxacin, ciprofloxacin, enoxacin or fleroxacin was examined in a rabbit model of left-sided endocarditis induced by P. aeruginosa [10]. Enoxacin and ciprofloxacin were equipotent and more effective in comparison with pefloxacin, ofloxacin and amikacin, whilst fleroxacin presented a weaker activity [10].…”

Diffusion of Ofloxacin in the Endocarditis Vegetation Assessed with Synchrotron Radiation UV Fluorescence Microspectrocopy

“…To maximize fluorescence detection, we administered a 150 mg/kg dose of ofloxacin, higher than doses previously used for experimental study of ofloxacin activity [15], [16]. As our model did not intend to reproduce the diffusion of ofloxacin in bacterial masses after a multiple human-like doses regimen, our results should not directly be extrapolated to what happens in patients.…”