Fig. 2.

Daptomycin efficacy optimized by a formulation of daptomycin ALT solution. Rats were infected with methicillin-resistant Staphylococcus epidermidis (MRSE) strain ATCC 49461 and monitored for 4 days to confirm the establishment of a mature biofilm. Groups of rats were then treated for 18 h daily for three consecutive days with ALT solutions as indicated (n = 6 rats/group). Rats receiving daptomycin ALT also received systemic daptomycin at 40 mg/kg daily via subcutaneous injection on each day of ALT. Animals were monitored for 7 days following the end of ALT, and tissues and fluids were then harvested for determinations of bacteremia and catheter-related metastatic infections. (A) Bacterial titers (means and standard deviations) in central venous catheter blood draws before (0 ALT), during (1 ALT and 2 ALT), and after (3 ALT) ALT, including terminal central venous catheter harvesting and cardiac blood draws 7 days following the cessation of ALT (3 ALT + 7 days). (B) Bacterial titers (means and standard deviations) measured at metastatic sites of infection, including the vena cava (surrounding the central venous catheter), heart, lung, kidneys, and spleen, 7 days following the end of 3 days of ALT.