Ds. Kernodle et Ab. Kaiser, COMPARATIVE PROPHYLACTIC EFFICACY OF CEFAZOLIN AND VANCOMYCIN IN A GUINEA-PIG MODEL OF STAPHYLOCOCCUS-AUREUS WOUND-INFECTION, The Journal of infectious diseases, 168(1), 1993, pp. 152-157
The increasing prevalence of methicillin-resistant Staphylococcus aure
us as a wound pathogen in some institutions has prompted the use of va
ncomycin for surgical prophylaxis, although clinical data comparing va
ncomycin and cephalosporins are not available. A guinea pig model was
used to compare the efficacy of vancomycin and cefazolin in preventing
intermuscular abscess formation by 7 S. aureus strains. Both antibiot
ics were administered to achieve peak serum levels at the time of bact
erial inoculation, and each remained > 1 mug/mL for a comparable durat
ion. Vancomycin provided equivalent protection from infection by 1 met
hicillin-susceptible strain and significantly better protection agains
t 4 methicillin-susceptible and both methicillin-resistant S. aureus s
trains. For most strains, the bacterial inoculum with a 50% probabilit
y of causing an abscess was 2 to 4 log10-fold higher with vancomycin t
han cefazolin prophylaxis. Prophylaxis with vancomycin is superior to
cefazolin in preventing intermuscular infection by methicillin-suscept
ible and -resistant S. aureus.