| Title | The prophylactic efficacy of rifampicin-soaked graft in combination with systemic vancomycin in the prevention of prosthetic vascular graft infection: an experimental study. | | Author(s) | Sacar M, Goksin I, Baltalarli A, Turgut H, Sacar S, Onem G, Ozcan V, Adali F | | Institution | Department of Cardiovascular Surgery, Pamukkale University, Faculty of Medicine, Denizli, Turkey. mustafasacar@hotmail.com | | Source | J Surg Res 2005 Dec; 129(2):329-34. | | MeSH | Animals
Anti-Bacterial Agents
Antibiotics, Antitubercular
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Disease Models, Animal
Drug Therapy, Combination
Male
Methicillin Resistance
Polyethylene Terephthalates
Polytetrafluoroethylene
Rats
Rats, Wistar
Rifampin
Staphylococcal Infections
Staphylococcus epidermidis
Vancomycin
| | Abstract | OBJECTIVE: To investigate the prophylactic efficacy of systemic, topical, or combined antibiotic usage in the prevention of late prosthetic vascular graft infection caused by methicillin-resistant Staphylococcus epidermidis (MRSE) and the differential adherence of S. epidermidis to Dacron and ePTFE grafts in a rat model.
MATERIALS AND METHODS: Graft infections were established in the back subcutaneous tissue of 120 adult male Wistar rats by implantation of 1-cm(2) Dacron/ePTFE prosthesis followed by topical inoculation with 2 x 10(7) CFU of clinical isolate of MRSE. Each of the series included one group with no graft contamination and no antibiotic prophylaxis (uncontaminated control), one contaminated group that did not receive any antibiotic prophylaxis (untreated control), one contaminated group in which perioperative intraperitoneal prophylaxis with vancomycin (10 mg/kg) was administered, two contaminated groups that received rifampicin-soaked (5 mg/1 ml) or vancomycin-soaked (1 mg/1 ml) grafts, and one contaminated group that received a combination of rifampicin-soaked (5 mg/1 ml) graft with perioperative intraperitoneal vancomycin prophylaxis (10 mg/kg). The grafts were removed sterilely 7 days after implantation and evaluated by using sonication and quantitative blood agar culture.
RESULTS: MRSE had significantly greater adherence to Dacron than ePTFE grafts in the untreated contaminated groups (P < 0.001). Rifampicin had better efficacy than vancomycin in topical application, but the difference was not statistically significant (P > 0.05). Intraperitoneal vancomycin showed a significantly higher efficacy than topical vancomycin or rifampicin (P < 0.001). The best results were provided by a combination of intraperitoneal vancomycin in rifampicin-soaked graft groups (P < 0.001).
CONCLUSIONS: The combination of rifampicin and intraperitoneal vancomycin seems to be the best choice for the prophylaxis of late prosthetic vascular graft infections caused by MRSE. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 16360378 |
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