Activity of moxifloxacin in combination with vancomycin or teicoplanin against Staphylococcus aureus isolated from device-associated infections unresponsive to glycopeptide therapy

J Chemother. 2003 Jun;15(3):239-43. doi: 10.1179/joc.2003.15.3.239.

Abstract

We tested the in vitro bactericidal activity of moxifloxacin, a new 8-methoxyquinolone, alone and in combination with vancomycin or teicoplanin at different multiples of minimum inhibitory concentration (MIC) against 8 methicillin-ciprofloxacin-resistant Staphylococcus aureus (M-C-RSA) and 1 methicillin-ciprofloxacin susceptible S. aureus (M-C-SSA) recently isolated from device-associated infections unresponsive to or relapsing after glycopeptide therapy, despite device removal. MICs of vancomycin ranged from 1 to 4 microg/ml, MICs of teicoplanin ranged from 2 to 8 microg/ml; MICs of moxifloxacin were always 2 microg/ml against M-C-RSA isolates and 0.125 microg/ml against the M-C-SSA isolate. The 9 strains resulted tolerant when tested for vancomycin, teicoplanin, and moxifloxacin used alone at 2 x MIC. In all cases the combination of moxifloxacin and teicoplanin or vancomycin appeared to be bactericidal already at MIC concentration for glycopeptides plus 0.5 x MIC concentration for moxifloxacin. If these results are confirmed in vivo in animal experiments, the combination of moxifloxacin with glycopeptides might be useful for treating device-associated infections, and in preventing the frightening phenomenon of increasing MICs for glycopeptides.

MeSH terms

  • Anti-Infective Agents / pharmacology*
  • Aza Compounds*
  • Catheterization / adverse effects*
  • Device Removal
  • Drug Interactions
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Fluoroquinolones*
  • Glycopeptides / therapeutic use*
  • Humans
  • Italy
  • Male
  • Methicillin Resistance*
  • Microbial Sensitivity Tests
  • Moxifloxacin
  • Quinolines*
  • Risk Assessment
  • Sensitivity and Specificity
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / isolation & purification
  • Teicoplanin / pharmacology*
  • Treatment Failure
  • Vancomycin / pharmacology*
  • Vancomycin Resistance*

Substances

  • Anti-Infective Agents
  • Aza Compounds
  • Fluoroquinolones
  • Glycopeptides
  • Quinolines
  • Teicoplanin
  • Vancomycin
  • Moxifloxacin