Center for Biofilm Engineering
Abstract:
"Comparative Evaluation of Oral Levofloxacin and Parenteral Nafcillin
in the Treatment of Experimental Methicillin-Susceptible Staphylococcus
aureus Osteomyelitis in Rabbits"
02-015 Methicillim-susceptible Staphylococcus
aureus (MSSA) is the most common pathogen recovered from osteomyelitis
patients. The current standard therapeutic method for acute phase osteomyelitis
is parenteral anitbiotic therapy. However, parental administration has negative
aspects, such as secondary infection, patient inconvenience and high cost. The
use of single oral antibiotic therapy may alleviate these problems. Therefore,
the purpose of this study was to compare the effectiveness of standard once per
day dosing of oral levofloxcin with a standard parenteral antibiotic regimen (nafcillin
four times daily) for the treatment of experimental MSSA osteomyelitis in
rabbits. Nearly all tibias from untreated infected controls (n = 27) revealed
positive cultures (93%) for S. aureus, while the levofloxacin- treated
group (n = 20) demonstrated significantly lower percentages of S. aureus
infection (50%). The infected tibias of the nafcillin-treated group (n = 20)
demonstrated significantly lower percentages (10%) of infected tibias than
wither the controls or the levoflaxcin-treated groups (p < 0.05). The
inferior efficacy of levoflaxcin may have been due to the pharmacokinetic
profile of this fluorouinolone. The serum kinetics demonstrated that
following single dose administration, levofloxacin was almost undetectable after
12 h. Studies in which levofloxacin is dosed every 12 h or given at increased
doses in order to obtain bactericidal concentrations throughout the treatment
regimen are needed.
Shirtliff, M.E., J.H. Calhoun, and J.T. Mader, "Comparative Evaluation
of Oral Levofloxacin and Parenteral Nafcillin in the Treatment of Experimental
Methicillin-Susceptible Staphylococcus aureus Osteomyelitis in
Rabbits," J Antimicrob. Chemother., 48:253-258 (2002). Abstract 02-015
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