Skip to main content
PMC home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1997 Sep;41(9):1916–1921. doi: 10.1128/aac.41.9.1916

Successful single-dose teicoplanin prophylaxis against experimental streptococcal, enterococcal, and staphylococcal aortic valve endocarditis.

G S Perdikaris 1, A Pefanis 1, H Giamarellou 1, A Nikolopoulos 1, E P Margaris 1, I Donta 1, A Tsitsika 1, P Karayiannakos 1
PMCID: PMC164035  PMID: 9303384

Abstract

Teicoplanin is a glycopeptide antibiotic that is administered both intramuscularly and intravenously. It has a prolonged half-life and a less toxic profile in comparison to those of vancomycin. The efficacy of a single dose of teicoplanin (18 mg/kg of body weight given intramuscularly) for the prevention of endocarditis due to Streptococcus oralis, Enterococcus faecium, and methicillin-resistant Staphylococcus aureus (MRSA) was evaluated after applying the rabbit model. Vancomycin at a single dose of 30 mg/kg given intravenously was used as the comparative agent for the prevention of endocarditis due to MRSA and E. faecium, while ampicillin at a single dose of 40 mg/kg given intravenously was used as the comparative agent for the prevention of endocarditis due to S. oralis. Rabbits in the teicoplanin group were infected at 1 h postdosing with approximately 10(7) CFU of each strain. Rabbits in the other groups were infected at 0.5 h postdosing with approximately 10(7) CFU of S. oralis (ampicillin group) or E. faecium and MRSA (vancomycin group). All rabbits were sacrificed 5 days later. Teicoplanin and vancomycin protected the animals challenged with E. faecium by 87.5 and 50%, respectively, and protected the animals challenged with MRSA by 100 and 92%, respectively. Teicoplanin and ampicillin protected the animals challenged with S. oralis by 100 and 77%, respectively. Prevention of endocarditis by teicoplanin was likely to be due to a prolonged inhibition of bacterial growth by the sustained supra-MICs. It is concluded that teicoplanin is very effective in preventing experimental streptococcal, enterococcal, and staphylococcal endocarditis and may be an attractive alternative antibiotic in patients allergic to beta-lactams, especially in the outpatient setting.

Full Text

The Full Text of this article is available as a PDF (214.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bayer A. S., Tu J. Chemoprophylactic efficacy against experimental endocarditis caused by beta-lactamase-producing, aminoglycoside-resistant enterococci is associated with prolonged serum inhibitory activity. Antimicrob Agents Chemother. 1990 Jun;34(6):1068–1074. doi: 10.1128/aac.34.6.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bernard J. P., Francioli P., Glauser M. P. Vancomycin prophylaxis of experimental Streptococcus sanguis. Inhibition of bacterial adherence rather than bacterial killing. J Clin Invest. 1981 Oct;68(4):1113–1116. doi: 10.1172/JCI110337. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Calain P., Waldvogel F. Clinical efficacy of teicoplanin. Eur J Clin Microbiol Infect Dis. 1990 Feb;9(2):127–129. doi: 10.1007/BF01963637. [DOI] [PubMed] [Google Scholar]
  4. Campoli-Richards D. M., Brogden R. N., Faulds D. Teicoplanin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic potential. Drugs. 1990 Sep;40(3):449–486. doi: 10.2165/00003495-199040030-00007. [DOI] [PubMed] [Google Scholar]
  5. Chambers H. F., Kennedy S. Effects of dosage, peak and trough concentrations in serum, protein binding, and bactericidal rate on efficacy of teicoplanin in a rabbit model of endocarditis. Antimicrob Agents Chemother. 1990 Apr;34(4):510–514. doi: 10.1128/aac.34.4.510. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cremieux A. C., Maziere B., Vallois J. M., Ottaviani M., Azancot A., Raffoul H., Bouvet A., Pocidalo J. J., Carbon C. Evaluation of antibiotic diffusion into cardiac vegetations by quantitative autoradiography. J Infect Dis. 1989 May;159(5):938–944. doi: 10.1093/infdis/159.5.938. [DOI] [PubMed] [Google Scholar]
  7. Dajani A. S., Bisno A. L., Chung K. J., Durack D. T., Freed M., Gerber M. A., Karchmer A. W., Millard H. D., Rahimtoola S., Shulman S. T. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. JAMA. 1990 Dec 12;264(22):2919–2922. [PubMed] [Google Scholar]
  8. Durack D. T. Prevention of infective endocarditis. N Engl J Med. 1995 Jan 5;332(1):38–44. doi: 10.1056/NEJM199501053320107. [DOI] [PubMed] [Google Scholar]
  9. Eliopoulos G. M. Increasing problems in the therapy of enterococcal infections. Eur J Clin Microbiol Infect Dis. 1993 Jun;12(6):409–412. doi: 10.1007/BF01967433. [DOI] [PubMed] [Google Scholar]
  10. Entenza J. M., Calandra T., Moosmann Y., Malinverni R., Glauser M. P. Teicoplanin versus vancomycin for prophylaxis of experimental Enterococcus faecalis endocarditis in rats. Antimicrob Agents Chemother. 1992 Jun;36(6):1256–1262. doi: 10.1128/aac.36.6.1256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Freedman L. R. To prevent or not to prevent bacterial endocarditis--that is the question! Clin Infect Dis. 1993 Aug;17(2):195–197. doi: 10.1093/clinids/17.2.195. [DOI] [PubMed] [Google Scholar]
  12. Glauser M. P., Bernard J. P., Moreillon P., Francioli P. Successful single-dose amoxicillin prophylaxis against experimental streptococcal endocarditis: evidence for two mechanisms of protection. J Infect Dis. 1983 Mar;147(3):568–575. doi: 10.1093/infdis/147.3.568. [DOI] [PubMed] [Google Scholar]
  13. Glauser M. P., Francioli P. Relevance of animal models to the prophylaxis of infective endocarditis. J Antimicrob Chemother. 1987 Sep;20 (Suppl A):87–98. doi: 10.1093/jac/20.suppl_a.87. [DOI] [PubMed] [Google Scholar]
  14. Hall G., Hedström S. A., Heimdahl A., Nord C. E. Prophylactic administration of penicillins for endocarditis does not reduce the incidence of postextraction bacteremia. Clin Infect Dis. 1993 Aug;17(2):188–194. doi: 10.1093/clinids/17.2.188. [DOI] [PubMed] [Google Scholar]
  15. Hess J., Dankert J., Durack D. Significance of penicillin tolerance in vivo: prevention of experimental Streptococcus sanguis endocarditis. J Antimicrob Chemother. 1983 Jun;11(6):555–564. doi: 10.1093/jac/11.6.555. [DOI] [PubMed] [Google Scholar]
  16. Malinverni R., Bille J., Glauser M. P. Single-dose rifampin prophylaxis for experimental endocarditis induced by high bacterial inocula of viridans streptococci. J Infect Dis. 1987 Jul;156(1):151–157. doi: 10.1093/infdis/156.1.151. [DOI] [PubMed] [Google Scholar]
  17. Mini E., Mazzei T., Reali E. F., Novelli A., Periti P. Pharmacokinetics of teicoplanin during cardiopulmonary bypass surgery. Int J Clin Pharmacol Res. 1989;9(4):287–292. [PubMed] [Google Scholar]
  18. Moellering R. C., Jr Emergence of Enterococcus as a significant pathogen. Clin Infect Dis. 1992 Jun;14(6):1173–1176. doi: 10.1093/clinids/14.6.1173. [DOI] [PubMed] [Google Scholar]
  19. Moreillon P., Francioli P., Overholser D., Meylan P., Glauser M. P. Mechanisms of successful amoxicillin prophylaxis of experimental endocarditis due to Streptococcus intermedius. J Infect Dis. 1986 Nov;154(5):801–807. doi: 10.1093/infdis/154.5.801. [DOI] [PubMed] [Google Scholar]
  20. Perdikaris G., Giamarellou H., Pefanis A., Donta I., Karayiannakos P. Vancomycin or vancomycin plus netilmicin for methicillin- and gentamicin-resistant Staphylococcus aureus aortic valve experimental endocarditis. Antimicrob Agents Chemother. 1995 Oct;39(10):2289–2294. doi: 10.1128/aac.39.10.2289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Perlman B. B., Freedman L. R. Experimental endocarditis. II. Staphylococcal infection of the aortic valve following placement of a polyethylene catheter in the left side of the heart. Yale J Biol Med. 1971 Oct;44(2):206–213. [PMC free article] [PubMed] [Google Scholar]
  22. Polk R. E. Anaphylactoid reactions to glycopeptide antibiotics. J Antimicrob Chemother. 1991 Apr;27 (Suppl B):17–29. doi: 10.1093/jac/27.suppl_b.17. [DOI] [PubMed] [Google Scholar]
  23. Pujadas R., Escriva E., Jane J., Argimon J., Fernandez F., Fava P., Galera M., Garau J. Tolerance and efficacy of parenterally administered penicillin-streptomycin and orally administered amoxicillin or penicillin V for prophylaxis of experimentally induced streptococcal endocarditis. Antimicrob Agents Chemother. 1990 Feb;34(2):321–325. doi: 10.1128/aac.34.2.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rowland M. Clinical pharmacokinetics of teicoplanin. Clin Pharmacokinet. 1990 Mar;18(3):184–209. doi: 10.2165/00003088-199018030-00002. [DOI] [PubMed] [Google Scholar]
  25. Schaad H. J., Chuard C., Vaudaux P., Waldvogel F. A., Lew D. P. Teicoplanin alone or combined with rifampin compared with vancomycin for prophylaxis and treatment of experimental foreign body infection by methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1994 Aug;38(8):1703–1710. doi: 10.1128/aac.38.8.1703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Scheld W. M., Zak O., Vosbeck K., Sande M. A. Bacterial adhesion in the pathogenesis of infective endocarditis. Effect of subinhibitory antibiotic concentrations on streptococcal adhesion in vitro and the development of endocarditis in rabbits. J Clin Invest. 1981 Nov;68(5):1381–1384. doi: 10.1172/JCI110388. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Shanson D. C., Shehata A., Tadayon M., Harris M. Comparison of intravenous teicoplanin with intramuscular amoxycillin for the prophylaxis of streptococcal bacteraemia in dental patients. J Antimicrob Chemother. 1987 Jul;20(1):85–93. doi: 10.1093/jac/20.1.85. [DOI] [PubMed] [Google Scholar]
  28. Somma S., Gastaldo L., Corti A. Teicoplanin, a new antibiotic from Actinoplanes teichomyceticus nov. sp. Antimicrob Agents Chemother. 1984 Dec;26(6):917–923. doi: 10.1128/aac.26.6.917. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Verbist L., Tjandramaga B., Hendrickx B., Van Hecken A., Van Melle P., Verbesselt R., Verhaegen J., De Schepper P. J. In vitro activity and human pharmacokinetics of teicoplanin. Antimicrob Agents Chemother. 1984 Dec;26(6):881–886. doi: 10.1128/aac.26.6.881. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Voorn G. P., Kuyvenhoven J., Goessens W. H., Schmal-Bauer W. C., Broeders P. H., Thompson J., Michel M. F. Role of tolerance in treatment and prophylaxis of experimental Staphylococcus aureus endocarditis with vancomycin, teicoplanin, and daptomycin. Antimicrob Agents Chemother. 1994 Mar;38(3):487–493. doi: 10.1128/aac.38.3.487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Voorn G. P., Thompson J., Goessens W. H., Schmall-Bauer W., Broeders P. H., Michel M. F. Role of tolerance in cloxacillin prophylaxis of experimental Staphylococcus aureus endocarditis. J Infect Dis. 1992 Jul;166(1):169–173. doi: 10.1093/infdis/166.1.169. [DOI] [PubMed] [Google Scholar]
  32. Wilson A. P., Grüneberg R. N. Use of teicoplanin in community medicine. Eur J Clin Microbiol Infect Dis. 1994 Sep;13(9):701–710. doi: 10.1007/BF02276052. [DOI] [PubMed] [Google Scholar]
  33. van der Meer J. T., van Vianen W., Hu E., van Leeuwen W. B., Valkenburg H. A., Thompson J., Michel M. F. Distribution, antibiotic susceptibility and tolerance of bacterial isolates in culture-positive cases of endocarditis in The Netherlands. Eur J Clin Microbiol Infect Dis. 1991 Sep;10(9):728–734. doi: 10.1007/BF01972497. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES