Open AccessEfficacy of Telavancin in Comparison to Linezolid in a Porcine Model of Severe Methicillin-Resistant Staphylococcus aureus Pneumonia
Author(s) -
Denise Battaglini,
Anna Motos,
Gianluigi Li Bassi,
Hua Yang,
Francesco Pagliara,
Minlan Yang,
Eli Aguilera Xiol,
Andrea Meli,
Joaquim Bobí,
Gerard Frigola,
Tarek Senussi,
Francesco Idone,
Chiara Travierso,
Chiara Chiurazzi,
Laia Fernández-Barat,
Montserrat Rigol,
José Ramírez,
Paolo Pelosi,
Davide Chiumello,
Massimo Antonelli,
David P. Nicolau,
Josep Bringué,
Antonio Artigas,
Laura Guerrero,
Dolors Soy,
Antoni Torres
Publication year - 2020
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.01009-20
Subject(s) - linezolid , medicine , bronchoalveolar lavage , pneumonia , staphylococcus aureus , methicillin resistant staphylococcus aureus , ventilator associated pneumonia , lung , vancomycin , microbiology and biotechnology , biology , bacteria , genetics
Current guidelines recommend vancomycin and linezolid as first-line agents against methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia. Telavancin is a potential new therapeutic alternative, specifically in monomicrobial MRSA pneumonia. This study compared the efficacies of telavancin versus linezolid in a porcine model of severe MRSA pneumonia. In 18 mechanically ventilated pigs (32.11 ± 1.18 kg), 75 ml of 10 6 CFU/ml of MRSA was administered into each pulmonary lobe. After the onset of pneumonia, pigs were randomized into three groups: a control group, a group receiving 22.5 mg/kg of body weight every 24 h (q24h) of telavancin, and a group receiving 10 mg/kg q12h of linezolid intravenously. Tracheal aspirate and bronchoalveolar lavage (BAL) fluids were cultured every 24 h. After 48 h of treatment, tissue samples were collected from the ventral and dorsal sections of each lobe. Microbiological and histopathological analyses were performed. Lung tissue concentrations differed among the groups ( P = 0.019), with the lowest MRSA lung burden in the telavancin group ( P < 0.05 versus the control). MRSA was detected in 46.7%, 40.0%, and 21.7% of the lung tissue samples from the control, linezolid, and telavancin groups, respectively ( P < 0.001). MRSA concentrations differed among the groups in tracheal aspirate fluid ( P = 0.011) but not in BAL fluid. Furthermore, there was no increased risk of kidney injury during telavancin use. Thus, telavancin has higher bactericidal efficacy than linezolid during the first 48 h of treatment in a porcine model of severe MRSA pneumonia. However, studies are needed to confirm the benefits of telavancin in treating MRSA nosocomial pneumonia.