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Comparative in vitro activity of vancomycin and levofloxacin in combination with rifampin against planktonic versus sessile cells of Staphylococcus epidermidis

Kang-Birken SL

Pharmacotherapy, 2000

Abstract

STUDY OBJECTIVE: To evaluate the activity of vancomycin and levofloxacin alone and combined with rifampin against planktonic and sessile cells.

INTERVENTION: Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of the three drugs were determined against a clinical isolate of methicillin-resistant Staphylococcus epidermidis (MRSE 23) and a reference strain of MRSE (ATCC 35984).

MEASUREMENTS AND MAIN RESULTS: The MICs/MBCs of vancomycin, levofloxacin, and rifampin against MRSE 23 were 0.78/0.78 microg/ml, 0.19/0.19 microg/ml or below, and 0.19/0.19 microg/ml or below, and against ATCC 35984 were 0.78/1.56 microg/ml, 0.19/0.19 microg/ml or below, and 0.19/0.19 microg/ml or below, respectively. A 99.9% killing activity was achieved with vancomycin, levofloxacin, and vancomycin-levofloxacin against planktonic cells of MRSE 23 (18.9, 21.3, and 17.5 hrs, respectively) and only with levofloxacin against ATCC 35984 (21.5 hrs). No regimen achieved 99.9% killing activity against sessile cells.

CONCLUSION: Adding rifampin was antagonistic against planktonic cells and had an additive effect against sessile cells. Activity typically reported using nutrient-rich, planktonic cells may not be applicable to sessile cells under environmental and growth restrictions.

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