Effect of Antibiotics on the Prevention of Experimental Bacteroides fragilis Endocarditis

The relative efficacy of single doses of antibiotics in modifying the development of Bacteroides fragilis subsp. fragilis endocarditis was studied in an experimental model. Antibiotics were administered 0.5 h before intravenous injection of B. fragilis subsp. fragilis into rabbits prepared by insertion of a polyethylene catheter into the left side of the heart; 48 h later, intracardiac vegetations were excised and cultured anaerobically. B. fragilis was recovered from 92% of untreated animals. After a single dose of procaine penicillin G (250 mg/kg intramuscularly), 80% of the animals remained infected. Chloramphenicol (30 mg/kg), carbenicillin (50 mg/kg), and metronidazole (10 mg/kg) were also ineffective (76, 80, and 75% infected, respectively). Cefamandole (30 mg/kg), cefoxitin (30 mg/kg), and erythromycin (30 mg/kg) were significantly more active (50, 55, and 45% infected, respectively), as were higher doses of carbenicillin. Clindamycin (50 mg/kg) was the most effective regimen (11% infected). At present, the relevance of these results to the therapy of serious B. fragilis infections is not known, but this model may prove useful in the evaluation of the prevention of B. fragilis subsp. fragilis bacteremia.