Modulation of efficacies and pharmacokinetics of antibiotics by granulocyte colony-stimulating factor in neutropenic mice with multidrug-resistant Enterococcus faecalis infection

被引:11
|
作者
Onyeji, CO
Nicolau, DP
Nightingale, CH [1 ]
Bow, L
机构
[1] Hartford Hosp, Dept Pharm Res, Hartford, CT 06102 USA
[2] Hartford Hosp, Div Infect Dis, Hartford, CT 06102 USA
[3] Hartford Hosp, Off Res Adm, Hartford, CT 06102 USA
[4] Obafemi Awolowo Univ, Fac Pharm, Ife, Nigeria
关键词
D O I
10.1093/jac/46.3.429
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
It has been demonstrated previously that, in non-neutropenic animals, interferon-gamma markedly enhances the efficacies of gentamicin and vancomycin against Enterococcus faecalis resistant to these antibiotics. The aim of our study was to determining whether granulocyte colony-stimulating factor (G-CSF) can be beneficial as an adjunct to gentamicin and vancomycin in the treatment of the same infection in neutropenic mice. After induction of neutropenia by cyclophosphamide, mice were inoculated ip with the organism. The infected animals received sc administrations of G-CSF, antibiotic or a combination of both agents at determined dosing regimens. Infected animals treated with G-CSF alone showed a dose-dependent increase in survival. The inoculum size used in establishing infection affected the effectiveness of the cytokine. Survival was significantly (P < 0.01) better in the infected animals given gentamicin and vancomycin plus G-CSF than in those given antibiotics or G-CSF alone. The possibility of pharmacokinetic interaction between G-CSF and each of the antibiotics was examined. The cytokine significantly increased the plasma clearance of gentamicin, with a resultant decrease in the area under the concentration-time curve (AUC), while the disposition of vancomycin was not affected. This study suggests that G-CSF may be a useful adjunct to gentamicin and vancomycin for the treatment of multidrug-resistant E. faecalis infection in neutropenic patients.
引用
收藏
页码:429 / 436
页数:8
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