Treatment of established prosthetic vascular graft infection with antibiotics preferentially concentrated in leukocytes.

Published

Journal Article

The efficacy of treating established vascular graft infections with rifampin and clindamycin (preferentially concentrated in leukocytes) and cefazolin (not concentrated in leukocytes) was studied in a canine model. Infrarenal aortic, 6 mm by 6 cm knitted Dacron double velour grafts were implanted and infected with 10(8) colony-forming units (CFU) of coagulase-positive Staphyloccus aureus organisms injected intravenously immediately after graft placement. Antibiotic therapy was instituted at 3 months postimplantation. Three groups were studied: (I) untreated controls (n = 3); (II) therapy with intravenous cefazolin 15 mg/kg/8 hr for 28 days (n = 7); and (III) combined therapy with intravenous rifampin 13 mg/kg/24 hr and intravenous clindamycin 13 mg/kg/8 hr for 28 days (n = 7). Grafts were removed for quantitative bacteriologic studies after the 28-day course of therapy. Two group I control grafts remained patent with 6.4 X 10(6) and 8.1 X 10(3) CFU S. aureus/gm of graft. The third control graft was thrombosed. Two group II animals demonstrated 1.6 X 10(7) and 2.3 X 10(5) CFU S. aureus organisms/gram of graft, respectively; the remaining five group II grafts were free of organisms. All group III grafts were sterile--a significant difference (p less than 0.05) from group I grafts. In this experimental model, established prosthetic graft infections were eradicated by intensive treatment with antibiotics preferentially concentrated in leukocytes.

Full Text

Duke Authors

Cited Authors

  • Wakefield, TW; Schaberg, DR; Pierson, CL; Bouffard, JA; Petry, NA; Nolan, KD; Spaulding, SA; Whitehouse, WM; Stanley, JC

Published Date

  • July 1, 1987

Published In

Volume / Issue

  • 102 / 1

Start / End Page

  • 8 - 14

PubMed ID

  • 3589979

Pubmed Central ID

  • 3589979

Electronic International Standard Serial Number (EISSN)

  • 1532-7361

International Standard Serial Number (ISSN)

  • 0039-6060

Language

  • eng