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Poeppl, W; Lingscheid, T; Bernitzky, D; Schwarze, UY; Donath, O; Perkmann, T; Kozakowski, N; Plasenzotti, R; Reznicek, G; Burgmann, H.
Efficacy of fosfomycin compared to vancomycin in treatment of implant-associated chronic methicillin-resistant Staphylococcus aureus osteomyelitis in rats.
Antimicrob Agents Chemother. 2014; 58(9):5111-5116
Doi: 10.1128/AAC.02720-13
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- Co-authors Med Uni Graz
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Schwarze Uwe Yacine
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Fosfomycin monotherapy was compared to therapy with vancomycin for the treatment of implant-associated methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis in an experimental rat model. The proximal tibiae were inoculated with 15 μl of a suspension containing 1×10(8) to 5×10(8) CFU/ml of a clinical isolate of MRSA with simultaneous insertion of a titanium wire. Four weeks later, treatment was started for 28 days with either 50 mg/kg of body weight vancomycin intraperitoneally twice daily (n=11) or 75 mg/kg fosfomycin intraperitoneally once daily (n=10). Eleven animals were left untreated. After treatment, quantitative cultures from bone were found to be positive for MRSA in all animals in the untreated group (median, 3.29×10(6) CFU/g of bone) and the vancomycin group (median, 3.03×10(5) CFU/g of bone). In the fosfomycin group, MRSA was detectable in 2 out of 10 (20%) animals (3.42×10(2) and 1.51×10(3) CFU/g of bone). Vancomycin was superior to the no-drug control (P=0.002), and fosfomycin was superior to the no-drug control and vancomycin (P<0.001). The cultures from the wires were positive in all untreated animals (median, 2.5×10(3) CFU/implant), in 10 animals in the vancomycin group (median, 1.15×10(3) CFU/implant), and negative in all animals in the fosfomycin group. Based on the bacterial counts from the implants, vancomycin was not superior to the no-drug control (P=0.324), and fosfomycin was superior to the no-drug control and vancomycin (P<0.001). No emergence of resistance was observed. In conclusion, it was demonstrated that fosfomycin monotherapy is highly effective for the treatment of experimental implant-associated MRSA osteomyelitis.
Copyright © 2014, American Society for Microbiology. All Rights Reserved.
- Find related publications in this database (using NLM MeSH Indexing)
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Animals -
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Anti-Bacterial Agents - pharmacology
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Fosfomycin - pharmacology
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Male -
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Methicillin - pharmacology
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Methicillin-Resistant Staphylococcus aureus - drug effects
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Microbial Sensitivity Tests - methods
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Osteomyelitis - drug therapy
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Osteomyelitis - microbiology
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Rats -
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Rats, Sprague-Dawley -
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Staphylococcal Infections - drug therapy
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Staphylococcal Infections - microbiology
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Vancomycin - pharmacology