In Vitro Activity of Ampicillin Plus Ceftriaxone Against Non-<i>faecalis</i> and Non-<i>faecium</i> Enterococcal Isolates With/Without VanC Phenotype: Clinical Implications for Infective Endocarditis

In Vitro Activity of Ampicillin Plus Ceftriaxone Against Non-<i>faecalis</i> and Non-<i>faecium</i> Enterococcal Isolates With/Without VanC Phenotype: Clinical Implications for Infective Endocarditis

(1) Background: Alternative antibiotics are needed to treat infective endocarditis (IE) caused by non-<i>faecalis</i>/non-<i>faecium</i> enterococci; we aimed to assess the in vitro activity of ampicillin plus ceftriaxone (AMP + CTR) against these enterococci and to describe...

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Main Authors: Javier García-González, María A. Cañas, Guillermo Cuervo, Marta Hernández-Meneses, Miguel A. Verdejo, Marta Bodro, Javier Díez de los Ríos, Oriol Gasch, Alba Ribera, Carles Falces, Andrés Perissinotti, Bárbara Vidal, Eduard Quintana, Asunción Moreno, Maria Piquet, Ignasi Roca, Mariana Fernández-Pittol, Sol M. San José-Villar, Cristina García-de-la-Mària, José M. Miró, the Hospital Clínic Endocarditis Study Group
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Microorganisms
Subjects:
enterococcal endocarditis
in vitro study
time–kill curves
synergy
<i>E. casseliflavus</i>
<i>E. gallinarum</i>
Online Access:https://www.mdpi.com/2076-2607/12/12/2511
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Summary:(1) Background: Alternative antibiotics are needed to treat infective endocarditis (IE) caused by non-<i>faecalis</i>/non-<i>faecium</i> enterococci; we aimed to assess the in vitro activity of ampicillin plus ceftriaxone (AMP + CTR) against these enterococci and to describe its clinical efficacy in IE cases. (2) Methods: Time–kill curves with standard (ISI) and high (IHI) inocula were performed to test <i>VanC</i> isolates [3 <i>E. casseliflavus</i> (ECAS) and 1 <i>E. gallinarum</i> (EGALL)] and non-<i>VanC</i> isolates [1 <i>E. durans</i> (EDUR), 1 <i>E. hirae</i> (EHIR) and 1 <i>E. raffinosus</i> (ERAF)]. The narrative literature review of IE cases treated with AMP + CTR was analyzed alongside three study cases. Clinical outcomes were relapse and death. (3) Results: Ampicillin plus gentamicin (AMP + GEN) showed synergistic and bactericidal activity against most isolates. AMP + CTR was synergistic at ISI for EGALL, EDUR, and EHIR and bactericidal against EHIR. At IHI, indifferent activity was observed for all isolates. In IE cases treated with AMP + CTR, it was only effective for EDUR and EHIR. Clinical information for EGALL IE is lacking. For IE caused by ECAS and ERAF, AMP + CTR seems suboptimal or ineffective, respectively. (4) AMP + CTR cannot be recommended for treating IE due to ECAS/ERAF. In contrast, this combination was effective in IE caused by EDUR/EHIR and could be recommended.
ISSN:2076-2607

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