Addition of daptomycin to levofloxacin increased the efficacy of levofloxacin monotherapy against a methicillin-susceptible Staphylococcus aureus strain in experimental meningitis and prevented development of resistance in vitro.

Cottagnoud, Philippe; Sprenker, Frederike; Cottagnoud, Marianne; Collaud, Alexandra; Ashkbus, Reza; Perreten, Vincent (2022). Addition of daptomycin to levofloxacin increased the efficacy of levofloxacin monotherapy against a methicillin-susceptible Staphylococcus aureus strain in experimental meningitis and prevented development of resistance in vitro. Journal of medical microbiology, 71(2) Microbiology Society 10.1099/jmm.0.001497

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Introduction. Daptomycin and levofloxacin were tested as monotherapies and in combination against the antibiotic-susceptible S. aureus strain MSSA 1112 in a rabbit meningitis model and the effect of the combination on induction of resistance was determined in vitro.
Hypothesis/Gap Statement. Treatment combination might be more efficacious than the monotherapies regarding antibacterial efficacy in vivo and development of resistance.
Aim. To demonstrate a synergy of the antibiotic combination daptomycin and levofloxacin in experimental meningitis, and also its ability to reduce the emergence of resistance against the antibiotics in vitro.
Methodology. Changes of the susceptibility to fluoroquinolones and daptomycin were determined by the measurement of the MIC and mutations were detected by whole genome sequence comparison of the mutants with the parent strain MSSA 1112. Meningitis was induced by intracisternal inoculation of 105 c.f.u. (colony forming unit) of MSSA 1112 and treatment was started 10 h later by injection of daptomycin (15 mg kg−1) and levofloxacin (10 mg kg−1) standard doses. Cerebrospinal fluid (CSF) samples were repeatedly collected during therapy in order to determine killing rates and results of bactericidal activity were expressed in Δlog10c.f.u. ml-1 over 8 h.

Results. The combination of daptomycin with levofloxacin was significantly (P<0.001) superior to levofloxacin monotherapy and increased the antibacterial activity of daptomycin. In vitro, MSSA 1112 was cycled over 6 days with either increasing concentrations of levofloxacin or daptomycin or with a combination of levofloxacin with half of the MIC of daptomycin or daptomycin with half of the MIC of levofloxacin leading to mutations in target genes as identified by whole genome sequence analysis. Addition of low concentration of daptomycin (0.25 mg l−1) reduced levofloxacin-induced resistance in vitro. Addition of levofloxacin in low concentration (0.125 mg l−1) did not influence daptomycin-induced resistance.
Conclusion. These findings highlight the lack of reciprocal interference of antibiotics in combination with regard to the development of resistance.

Item Type:

Journal Article (Original Article)

Division/Institute:

05 Veterinary Medicine > Department of Infectious Diseases and Pathobiology (DIP) > Institute of Veterinary Bacteriology > Molecular Bacterial Epidemiology and Infectiology
05 Veterinary Medicine > Department of Infectious Diseases and Pathobiology (DIP)
05 Veterinary Medicine > Department of Infectious Diseases and Pathobiology (DIP) > Institute of Veterinary Bacteriology

UniBE Contributor:

Collaud, Alexandra, Perreten, Vincent

Subjects:

500 Science
500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1473-5644

Publisher:

Microbiology Society

Language:

English

Submitter:

Vincent Perreten

Date Deposited:

07 Mar 2022 15:10

Last Modified:

05 Dec 2022 16:08

Publisher DOI:

10.1099/jmm.0.001497

PubMed ID:

35108179

Uncontrolled Keywords:

S. aureus antibacterial resistance daptomycin experimental meningitis levofloxacin

URI:

https://boris.unibe.ch/id/eprint/165625

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