Antibiotic Prophylaxis of Experimental Endocarditis Due to Methicillin-Resistant Staphylococcus epidermidis

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Abstract
Antibiotic prophylaxis for the prevention of endocarditis due to methicillin-resistant S. epidermidis (MRSE) was evaluated in a modified rabbit endocarditis model and compared with results obtained with methicillin-sensitive S. epidermidis (MSSE). One dose of nafcillin, cefamandole, cephalothin or vancomycin neither prevented endocarditis nor sterilized the blood of rabbits challenged with each of 2 MRSE or 2 MSSE isolates. One dose of gentamicin protected .gtoreq. 80% of animals challenged with 3 of the 4 isolates and 1 dose of rifampin protected .gtoreq. 90% challenged with any of the 4 isolates. Multiple doses of any of the antibiotics prevented endocarditis in .gtoreq. 80% of rabbits challenged with MSSE and 4 doses of vancomycin protected rabbits challenged with MRSE. MRSE endocarditis was prevented in .ltoreq. 25% of animals given 6 doses of nafcillin or cephalosporins. Nafcillin and cephalosporins were ineffective prophylaxis for MRSE endocarditis, whereas vancomycin, gentamicin and rifampin were effective.