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Once-daily gentamicin therapy for experimental Escherichia coli meningitis.
- Source :
-
Antimicrobial agents and chemotherapy [Antimicrob Agents Chemother] 1997 Jan; Vol. 41 (1), pp. 49-53. - Publication Year :
- 1997
-
Abstract
- In vitro and in vivo studies have demonstrated that the bacteriologic efficacy of once-daily aminoglycoside therapy is equivalent to that achieved with conventional multiple daily dosing. The impact of once-daily dosing for meningitis has not been studied. Using the well-characterized rabbit meningitis model, we compared two regimens of the same daily dosage of gentamicin given either once or in three divided doses for 24 or 72 h. The initial 1 h mean cerebrospinal fluid (CSF) gentamicin concentration for animals receiving a single dose (2.9 +/- 1.7 micrograms/ml) was threefold higher than that for the animals receiving multiple doses. The rate of bacterial killing in the first 8 h of treatment was significantly greater for the animals with higher concentrations in their CSF (-0.21 +/- 0.19 versus -0.03 +/- 0.22 log10 CFU/ml/h), suggesting concentration-dependent killing. By 24h, the mean reduction in bacterial titers was similar for the two regimens. In animals treated for 72 h, no differences in bactericidal activity was noted for 24, 48, or 72 h. Gentamicin at two different dosages was administered intracisternally to a separate set of animals to achieve considerably higher CSF gentamicin concentrations. In these animals, the rate of bacterial clearance in the first 8 h (0.52 +/- 0.15 and 0.58 +/- 0.15 log10 CFU/ml/h for the lower and higher dosages, respectively) was significantly greater than that in animals treated intravenously. In conclusion, there is evidence of concentration-dependent killing with gentamicin early in treatment for experimental E. coli meningitis, and once-daily dosing therapy appears to be at least as effective as multiple-dose therapy in reducing bacterial counts in CSF.
- Subjects :
- Animals
Anti-Bacterial Agents administration & dosage
Anti-Bacterial Agents cerebrospinal fluid
Cisterna Magna
Colony Count, Microbial
Escherichia coli drug effects
Gentamicins administration & dosage
Gentamicins cerebrospinal fluid
Injections
Injections, Intravenous
Rabbits
Anti-Bacterial Agents therapeutic use
Escherichia coli Infections drug therapy
Gentamicins therapeutic use
Meningitis, Bacterial drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0066-4804
- Volume :
- 41
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Antimicrobial agents and chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 8980753
- Full Text :
- https://doi.org/10.1128/AAC.41.1.49