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Efficacy of Trovafloxacin against Experimental Staphylococcus aureus Endocarditis
Authors:Glenn W. Kaatz  Susan M. Seo  Jeffrey R. Aeschlimann  Heather H. Houlihan  Reneé-Claude Mercier  Michael J. Rybak
Affiliation:Department of Internal Medicine, Division of Infectious Diseases, School of Medicine,1. Department of Veteran’s Affairs Medical Center,2. and College of Pharmacy and Allied Health Professions,3. Wayne State University, and The Anti-Infective Research Laboratory, Department of Pharmacy Services, Detroit Receiving Hospital and University Health Center,4. Detroit, Michigan 48201
Abstract:Trovafloxacin is a new fluoronaphthyridone chemically and functionally related to members of the fluoroquinolone class of antimicrobial agents. The in vivo efficacy of the drug was compared with that of vancomycin by using the rabbit model of left-sided endocarditis. Rabbits infected with either a nafcillin-susceptible or -resistant test strain were treated with trovafloxacin (13.3 mg/kg of body weight every 12 h) or vancomycin (25 mg/kg of body weight every 8 h) for 4 days. In comparison with untreated controls, both antimicrobial agents effectively cleared bacteremia and significantly reduced bacterial counts in vegetations and tissues of animals infected with either test strain. No resistance to trovafloxacin emerged in test strains during therapy. We conclude that in this model trovafloxacin is as efficacious as vancomycin is and may serve as a viable alternative to vancomycin for use in humans with similar infections.Trovafloxacin (CP-99,219-27) is a fluoronaphthyridone antimicrobial agent related to fluoroquinolones such as ciprofloxacin and norfloxacin (2). It has potent activity against a broad range of bacterial species, including Staphylococcus aureus (4, 5, 15, 17, 22). The antibacterial activity of trovafloxacin versus S. aureus surpasses that of ciprofloxacin, and trovafloxacin may maintain clinically relevant activity against ciprofloxacin-resistant strains (1).The in vivo activity of trovafloxacin against selected pathogens has been assessed by using animal models, and the drug has shown therapeutic efficacy comparable to that of standard forms of therapy (3, 6, 13, 21). However, the efficacy of trovafloxacin in treating serious S. aureus infections has not been determined. In order to address this issue, we compared the therapeutic activities of trovafloxacin and vancomycin by using the rabbit model of left-sided S. aureus endocarditis. This model affords a severe test of antimicrobial activity in a serious systemic infection.
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