Efficacy of rifampin-levofloxacin as a prophylactic agent in preventing Staphylococcus epidermidis graft infection

Objectives: to investigate the efficiency of levofloxacin in the prevention of vascular prosthetic fraft infection in a rat model. Methods: graft infections were established in the subcutaneous tissue of 22 5 male Wistar rats by implantation of Dacron prostheses followed by topical inoculation with methicillin-susceptible and methicillin-resistant S. epid ermidis. The study included a group without contamination, two contaminated groups without prophylaxis, two contaminated groups with intraperitoneal l evofloxacin prophylaxis, two contaminated groups with intraperitoneal cefaz olin prophylaxis, two contaminated groups with intraperitoneal teicoplanin prophylaxis and six contaminated groups with rifampin-soaked graft and intr aperitoneal levofloxacin, cefazolin or teicoplanin prophylaxis. The grafts were removed after 7 days and evaluated by quantitative culture. Results: the efficacy of levofloxacin against the methicillin-susceptible s train was not different to that of cefazolin or leicoplanin. Levofloxacin s howed slight less efficicacy than teicoplanin against the methicillin-resis tant strain. The combination levofloxacin-rifampin demonstrated to be simil arly effective to the combination rifampin-teicoplanin and more effective t han the combination rifampin-cefazolin against both strains. Conclusions: rifampin-levofloxacin combination seems useful for the prevent ion of late-appearing vascular graft infections caused by S. epidermidis.