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PubMed2000

Problems and perils of vancomycin resistant enterococci.

Enterococci have been a therapeutic challenge for haIfa century; first in the management of endocarditis, then associated with the emergence of resistance to streptomycin and later to all aminoglycosides, and now with the increasing levels of resistance to penicillins. A major leap in the problem of antimicrobial resistance occurred more than a decade ago when vancomycin resistant enterococci (VRE) were first identified. This resulted from the acquisition by Enterococcus faecium of vancomycin resistant genes. Five types of vancomycin resistance have since been described (VanA-VanE) and others also appear to exist. VanA and VanB are caused by complex gene clusters that may be plasmid and/or transposon encoded. As a result of the gene cluster, cell wall precursors in the bacteria are formed that do not allow effective vancomycin binding, thus the action of vancomycin to inhibit cell wall synthesis is prevented. Therapy of infections caused by VRE is difficult, but a number of potentially effective antibiotics are now being tested in humans, including quinupristin/dalfopristin, linezolid, evernimomycin, daptomycin and LY333328. Combinations of antibiotics such as ampicillin with quinupristin/dalfopristin or with imipenem, and newer fluoroquinolones are also being evaluated. Until the time when these drugs become available, we must rely on careful monitoring of microbial transmission in hospitals, and we must utilize multi-faceted approaches to prevent the increase in the number and spread of VRE.

Enterococcus↗

PubMed2000

[Resistance and new antibiotic strategies. The other new molecules].

ANTI-PNEUMOCOCCAL DRUGS: New fluoroquinolones with different targets than earlier compounds have been found to be active in certain cases of respiratory tract pneumococcal infections. Moxifloxacin, levofloxacin and gatifloxacin have been particularly effective. These new antibiotics can be classed in a new category of "respiratory quinolones". EFFLUX PUMP INHIBITORS: The bacterial efflux systems are complex resistance mechanisms allowing the bacteria to expulse certain antibiotics belonging to several drug families and thus to develop multiple resistance capacities. A new series of efflux pump inhibitors has been recently synthesized. Associated with an antibiotic (levofloxacin, macrolide) these inhibitors significantly increase antibacterial activity. BACTERIAL WALL INHIBITORS: These compounds target the biosynthesis units of the bacterial walls, inhibiting for example bacterial enzyme Mur A. CYCLIC LIPOPEPTIDES: These include daptomycin which acts on peptidoglycan synthesis in the bacterial wall via a mechanism different from that of glycopeptides. NEW BETA-LACTAMS: Faropenem is a new member of the penem family. Ceftidoren is an oral cephalosporin that gives 64 to 70% cure after 7 to 10 days in cases of acute maxillary sinusitis and 81 to 83% in exacerbations of acute bronchial infections. In streptococcal pharyngitis in adults, ceftidoren produces better eradication (90%) of S. pyogenes than penicillin V (83%) at treatment end.

Anti-Bacterial Agents↗

PubMed2001

[Antibacterial chemotherapy--are we really at the end of the antibiotic era?].

Antimicrobial chemotherapy undergoes a global crisis. The nineties brought the unprecedented spread of resistance of main pathogenic bacteria to antibiotics, with an extent and intensity varying from negligible to threatening, depending largely on the local or regional or nationwide approach to prescribing antibiotics. In some reqions the microbial multiresistance led to various bacterial infections becoming untreatable, however, substantial increase of costs of antibacterial chemotherapy--somewhere even prohibitive--has been felt everywhere, depending on the necessity of using reserve drugs instead of basic ones. In he mid of nineties, the advent of a post-antibiotic era seemed almost inevitable. Concentrated efforts aimed at rationalizing the antibiotic usage, at decreasing the useless prescribing, at creating antibiotic policies as well as the development of new at the antibacterials have diminished the danger, at least for some time. Brief descriptions of new drugs (linezolide, quinupristine/dalfoprostine, new chinolones and naphythyridones and telithromycine) are given and some other, in the near future possibly useful antibacterials (daptomycine, glycycyclines, oral carbapenems and trinems) are mentioned as well as some new ways of antibacterial research. In a long-term view, however, rationalization of antibiotic prescribing is the only and irreplaceable mean of maintaining the efficacy of antibacterial chemotherapy at acceptable costs.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Gram-positive bacterial infections resistant to antibiotic treatment].

Antibiotic resistance has become a major problem in the treatment of gram-positive bacterial infections. These organisms are able to escape antibiotic activity through several mechanisms including beta-lactamase production, altered penicillin-binding proteins, aminoglycoside-modifying enzymes, modification of the target site of the antibiotic, and active efflux. Resistant determinants may be carried on the chromosome, and are transmitted vertically by clonal dissemination, or on mobile elements such as plasmids, transposons or integrons capable of horizontal transfer both within and between species. Several resistant genes can be inserted in a given integron, resulting in multi-drug resistance. Antimicrobial resistance mechanisms can be caused or induced following the widespread use of antibiotics. The most important gram-positive resistant organisms include penicillin-resistant Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, methicillin-resistant Staphylococcus aureus with intermediate resistance to vancomycin, and enterococcal strains that express high-level resistance to aminoglycosides and/or resistance to vancomycin. In several instances, these strains show multi-drug resistance and cannot be treated with currently available agents. Therapeutic strategies include the use of a higher antibiotic dosage, the use of alternative, non-conventional drugs, alone or in combination, after demonstration of their efficacy in vitro and in experimental animal models, and the development of new drugs. New agents available include quinupristin/dalfopristin and line-zolid with activity against most resistant gram-positive bacteria. Promising new drugs that may reach the market in the near future include daptomycin and oritavancin. Careful use of antibiotics and adherence to infection control standards are crucial in preventing the development and the spread of resistant organisms.

Drug Resistance, Microbial↗

PubMed2002

Gateways to Clinical Trials.

Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Studies knowledge area of Prous Science Integrity, the world's first drug discovery and development portal, and provides information on study design, treatments, conclusions and references. This issue focuses on the following selection of drugs: Abiciximab, acetylcholine chloride, acetylcysteine, alefacept, alemtuzumab, alicaforsen, alteplase, aminopterin, amoxicillin sodium, amphotericin B, anastrozole, argatroban monohydrate, arsenic trioxide, aspirin, atazanavir, atorvastatin, augmerosen, azathioprine; Benzylpenicillin, BMS-284756, botulinum toxin type A, botulinum toxin type B, BQ-123, budesonide, BXT-51072; Calcium folinate, carbamazepine, carboplatin, carmustine, ceftriaxone sodium, cefuroxime axetil, chorionic gonadotropin (human), cimetidine, ciprofloxacin hydrochloride, cisplatin, citalopram hydrobromide, cladribine, clarithromycin, clavulanic acid, clofarabine, clopidogrel hydrogensulfate, clotrimazole, CNI-1493, colesevelam hydrochloride, cyclophosphamide, cytarabine; Dalteparin sodium, daptomycin, darbepoetin alfa, debrisoquine sulfate, dexrazoxane, diaziquone, didanosine, docetaxel, donezepil, doxorubicin hydrochloride liposome injection, DX-9065a; Eberconazole, ecogramostim, eletriptan, enoxaparin sodium, epoetin, epoprostenol sodium, erlizumab, ertapenem sodium, ezetimibe; Fampridine, fenofibrate, filgrastim, fluconazole, fludarabine phosphate, fluorouracil, 5-fluorouracil/epinephrine, fondaparinux sodium, formoterol fumarate; Gabapentin, gemcitabine, gemfibrozil, glatiramer; Heparin sodium, homoharringtonine; Ibuprofen, iloprost, imatinib mesilate, imiquimod, interferon alpha-2b, interferon alpha-2c, interferon-beta; KW-6002; Lamotrigine, lanoteplase, metoprolol tartrate, mitoxantrone hydrochloride; Naproxen sodium, naratriptan, Natalizumab, nelfinavir mesilate, nevirapine, nifedipine, NSC-683864; Oral heparin; Paclitaxel, peginterferon alfa-2b, phenytoin, pimecrolimus, piperacillin, pleconaril, pramipexole hydrochloride, prednisone, pregabalin, progesterone; Rasburicase, ravuconazole, reteplase, ribavirin, rituximab, rizatriptan, rosiglitazone maleate, rotigotine; Semaxanib, sildenafil citrate, simvastatin, stavudine, sumatriptan; Tacrolimus, tamoxifen citrate, tanomastat, tazobactam, telithromycin, tenecteplase, tolafentrine, tolterodine tartrate, triamcinolone acetonide, trimetazidine, troxacitabine; Valproic acid, vancomycin hydrochloride, vincristine, voriconazole, Warfarin sodium; Ximelagatran, Zidovudine, zolmitriptan.

Clinical Trials as Topic↗

PubMed2002

Gram-positive bacterial resistance. A challenge for the next millennium.

Penicillin G was first used in 1941. Since then, the trend in bacterial infections has changed. New antibiotics have been developed and bacterial resistance has spread as a consequence. The spread of Gram positive resistant bacteria is related to an inappropriate use of antibiotics. Antibacterial agents are abused or overused in various fields: medicine itself, veterinary science and zootechnics. Now, at the beginning of the third millennium we have been forced to limit our therapeutic options in order to combat these insidious enemies. Selective antibiotic pressure on the microbial population, notably on enterococci and staphylococci, made these two pathogens recalcitrant to traditional chemotherapy. It is a matter of concern that today, vancomycin-resistant Enterococcus spp. (VRE) and vancomycin-intermediate and resistant Staphylococcus aureus (VISA and VRSA) are now being observed worldwide among emerging pathogens. Most pharmaceutical companies are today developing antimicrobial drugs that are active against Gram-positive bacteria. Quinupristin/dalfopristin and linezolid are the most promising drugs and are available only for serious infections; future agents being developed for multi-resistant Gram-positive infections include daptomycin and the glycyclines, although these are still in the development phase. Nevertheless, our group has had the opportunity to treat some serious infections with these drugs and the good results achieved are reported in this review.

Acetamides↗

PubMed2002

[Risk factors and treatment of methicillin-resistant Staphylococcus aureus infections].

METICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS (MRSA): The maintenance of a catheter in febrile neutropenic patients with MRSA bacteremia is justified, except when the latter persists 2 to 3 days after the initiation of treatment. Prior administration of fluoroquinolones (levofloxacine or ciprofloxacine) is a risk factor significantly associated with the isolation of MRSA. Meticillin resistance is not a factor of mortality in HIV-infected patients exhibiting S. aureus bacteremia. Surveillance blood cultures represent a simple method for identifying patients at high risk of secondary foci. INFECTIONS WITH GLYCOPEPTIDE-INTERMEDIATE MRSA (HETERO-GISA): In liver transplant recipients, the risk of acquiring a hetero-GISA is not associated with prior MRSA infection nor prior glycopeptide treatment. It is significantly associated with the occurrence of an infectious episode in the weeks preceding the transplant and with the administration of beta-lactams during the previous two months. Mortality is not increased in patients with hetero-GISA. NEW ANTIBIOTICS: Linezolide and quinupristine-dalfopristine are new agents available for the treatment of MRSA infection. Other antibiotics under development have demonstrated their activity: lipopeptides (daptomycin), semi-synthetic glycopeptides (oritavancin, dalbavancin), glycylglycines (tigecyclin), carbapenems (CP5609), and cephalosphorins (LB 11058). ANTIBIOTIC COMBINATIONS: Various studies have shown that antibiotic combinations must be used with care in the treatment of MRSA and GISA infections (glycopeptide intermediate strains) because of the antagonism between molecules belonging to different families.

Anti-Bacterial Agents↗

PubMed2003

Gram-positive bacterial resistance: future treatment options.

Gram-positive infections are a major burden on patients and healthcare systems globally, and the need to treat these infections correctly in an empirical manner has become paramount. Further complicating this changing etiology is the emergence of resistant strains which are no longer predictably susceptible to standard first-line antimicrobials such as oxacillin or vancomycin. Thus, new agents such as linezolid have been developed to alleviate the 'guesswork' of initial empirical prescribing in infections where Gram-positive pathogens may be present. Future agents also being developed for multiresistant Gram-positive infections include evernimicin antibiotics, daptomycin, oritavancin, glycylcyclines and novel broad-spectrum cephalosporins; however, these are still in the development phase.

Anti-Infective Agents↗

PubMed2003

Gateways to clinical trials.

Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Studies Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: Abarelix, ABX-EGF, ademetionine, agomelatine, AMGN-0007, 9-aminocamptothecin, AN-9, anecortave acetate, anidulafungin, AOD-9604, apolizumab, apomate, L-arginine hydrochloride, arzoxifene hydrochloride; Bevacizumab, BP-897, BufferGel; Capravirine, carboxyamidotriazole, carnosine, CC-4047, CEP-701, cerivastatin sodium, clofarabine, conivaptan hydrochloride, CP-461, CS-003; Daptomycin, darifenacin, decitabine, deferasirox, duloxetine hydrochloride; Eberconazole, Ecyd, efalizumab, eglumegad hydrate, EMD-72000, (-)-epigallocatechin gallate, exatecan mesilate, exenatide; Fampridine, fenretinide, ferumoxtran-10; Gadofosveset sodium, garenoxacin mesilate, genistein, glutamine, GPI-15715; Hexyl insulin M2, human insulin, HYB-165; Indisulam, irofulven; KRN-5500, L-796568, laurocapram, lidocaine/prilocaine, lonafarnib, lotrafiban; Melagatran, melatonin, 2-methoxyestradiol, metreleptin, motexafin gadoliniu, motexafin lutetium; Natalizumab, nelarabine, NO-aspirin, NSC-683864; ONO-6126; Pemetrexed disodium, pexelizumab, pirfenidone, PncCRM9, polyglutamate paclitaxel, pramlintide acetate pregabalin, PRO-2000; Ragaglitazar, ramelteon, rasagiline mesilate, rDNA insulin, recombinant glucagon-like peptide-1 (7-36) amide, recombinant human parathyroid hormone (1-84), reolysin RG228, roflumilast, roxifiban acetate, RPI-4610, rubitecan; Safinamide mesilate, solifenacin succinate, SRL-172; T-138067, tafenoquine succinate, tecadenoson, TER-286, tesaglitazar, tetrathiomolybdate, tezosentan disodium, TheraCIM, tigecycline, tipifarnib, tolvaptan, trabectedin, tributyrin, trimegestone, troxacitabine; UCN-01, urokinase alfa; Vinflunine, viscum fraxini 2; Xcellerated T cells, ximelagatran.

Clinical Trials as Topic↗

PubMed1992

Future trends in antibiotic therapy.

The 1990s will probably see fewer new antibiotics being registered than occurred during the 1970s and 1980s. The main reason for this is the excessive costs involved in the development of a new chemical entity. It is probable that more fluoroquinolones will be introduced and some of them will have improved antibacterial activities compared to current derivatives. Another class of antibiotics likely to develop during the next decade is the macrolides, with the emergence of drugs like azithromycin. Among the beta-lactams, new carbapenems and extended spectrum cephalosporins will be developed to meet the problems of increasing numbers of enterobacteria producing class I beta-lactamases, as well as the new broad-spectrum TEM enzymes. These resistance mechanisms against beta-lactams are also likely to give rise to a new era for beta-lactamase inhibitors. A field which presently looks less promising is that of drugs which are active against methicillin-resistant staphylococci; teicoplanin and daptomycin seem to have only minor advantages over vancomycin. Other developments that can be expected are those facilitating the administration of antibiotics, especially once-daily injectable antibiotics for intensive home care.

Anti-Bacterial Agents↗

PubMed2004

Gateways to clinical trials.

Clinical Trials as Topic↗

PubMed2004

Vancomycin intermediate and resistant Staphylococcus aureus. What the nephrologist needs to know.

Individuals undergoing hemodialysis may be at increased risk for emerging antimicrobial resistance from vancomycin-intermediate Staphylococcus aureus (VISA) and vancomycin-resistant S. aureus (VRSA). The laboratory detection of VISA and VRSA is challenging and requires the use of well-thought-out algorithms. Newly available antimicrobials such as quinipristin/dalfopristin, linezolid, and daptomycin, as well as older drugs such as trimethoprim-sulfamethoxazole appear to be active against recent strains of VISA and VRSA. Prevention of VISA and VRSA necessitates determining the appropriateness of vancomycin use in renal patients and giving priority to infection control precautions in both inpatient and outpatient settings. Because most VISA and all VRSA to date have arisen from endemic methicillin-resistant S. aureus (MRSA), and in the case of VRSA have acquired genes from vancomycin-resistant enterococci (VRE), the emergence of VISA and VRSA should provide renewed motivation for the containment of MRSA and VRE transmission in the hemodialysis population.

Adult↗

PubMed2005

New strategies for the treatment of infections associated with prosthetic joints.

Treatment of infections associated with orthopedic devices usually requires appropriate surgical intervention combined with a prolonged course of antimicrobial therapy. The choice of optimal management depends on duration and pathogenesis of infection, stability of the implant, antimicrobial susceptibility of the pathogen and condition of the soft tissue. The role of rifampin in combination with quinolones, minocycline, co-trimoxazole or fusidic acid in the treatment of staphylococcal infections is outlined in this review. Increasing antimicrobial resistance requires the use of alternative agents, such as quinupristin-dalfopristin, linezolid and daptomycin, but results of clinical trials are limited. Finally, agents with a potential for treatment or prophylaxis of device-associated infections, such as novel rifamycin derivatives, and compounds acting on bacterial quorum-sensing mechanisms are presented in this review.

Animals↗

PubMedDate not supplied

Antimicrobial-resistant gram-positive bacteria in PD peritonitis and the newer antibiotics used to treat them.

The incidence of resistant gram-positive bacteria in nosocomial and, more recently, community-acquired infections is increasing. Staphylococci, because of their natural habitat on the skin, have always been the leading cause of peritonitis in patients receiving peritoneal dialysis (PD). These organisms have demonstrated a remarkable ability to develop resistance to antibiotics, first with penicillin, then antistaphylococcal penicillins (methicillin-resistant Staphylococcus aureus), and more recently, strains expressing resistance to vancomycin (vancomycin-intermediate and vancomycin-resistant S. aureus) have emerged. Enterococci are normal inhabitants of the gastrointestinal tract and occasionally cause PD peritonitis. In the past 15 years, vancomycin-resistant enterococci have emerged as significant pathogens in many areas. In the past 5 years, novel antibiotics that have activity on gram-positive bacteria, including vancomycin-resistant strains, have become available. The problem of resistant gram-positive bacteria in PD peritonitis, their therapy, and the role of these newer agents, quinupristin/dalfopristin, linezolid, and daptomycin, are reviewed.

Anti-Bacterial Agents↗

PubMed2005

Gateways to clinical trials.

Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: (-)-Epigallocatechin gallate, (Z)-4-hydroxytamoxifen; Ad.muIFN-beta AD-237, adalimumab, adefovir dipivoxil, agalsidase alfa, alemtuzumab, almotriptan, ALVAC vCP1452, alvimopan hydrate, ambrisentan, anakinra, anti-IFN-gamma MAb; Bimatoprost, BMS-188797, BMS-214662, bortezomib, bosentan, bovine lactoferrin; Caffeine, canertinib dihydrochloride, canfosfamide hydrochloride, cannabidiol, caspofungin acetate, cetuximab, cH36, ChimeriVax-JE, ciclesonide, cilansetron, cinacalcet hydrochloride, clopidogrel, CpG-7909, Cypher; Daptomycin, darbepoetin alfa, darifenacin hydrobromide, decitabine, denufosol tetrasodium, Dexamet, diindolemethane, drotrecogin alfa (activated), duloxetine hydrochloride, DX-9065a; E-7010, edaravone, efalizumab, eicosapentaenoic acid/docosahexaenoic acid, elacridar, eletriptan, emtricitabine, epratuzumab, erlotinib hydrochloride, ertapenem sodium, eszopiclone, everolimus, ezetimibe; Fludarabine, fondaparinux sodium; gamma-Hydroxybutyrate sodium, gavestinel sodium, gefitinib, granisetron-Biochronomer; Human Albumin, human insulin; Imatinib mesylate, indiplon, interleukin-2 XL, isatoribine, ISS-1018, i.v. gamma-globulin, ivabradine hydrochloride, ixabepilone; Lanthanum carbonate, L-arginine hydrochloride, liposomal doxorubicin, LY-450139; Magnesium sulfate, melatonin, motexafin gadolinium, mycophenolic acid sodium salt; Natalizumab, nesiritide, niacin/lovastatin; OGX-011, olmesartan medoxomil, omalizumab, ospemifene; PACAP38, panitumumab, parathyroid hormone (human recombinant), parecoxib sodium, patupilone, pegfilgrastim, peginterferon alfa-2a, peginterferon alfa-2b, peginterferon alfa-2b/ribavirin, pemetrexed disodium, pimecrolimus, pirfenidone, posaconazole, prasterone, pregabalin; R-112, ramelteon, ranolazine, rasagiline mesilate, rebimastat, roflumilast, rosuvastatin calcium, rotigotine hydrochloride, rupatadine fumarate; S-3013, S-3304, semustine, sitaxsentan sodium, St. John's Wort extract; Tadalafil, tamoxifen, Taxus, Tc-99m-EDDA-HYNIC-TOC, TH-9507, tiotropium bromide, tipifarnib, tocilizumab, tolvaptan, torcetrapib, TR-14035, tramadol hydrochloride/acetaminophen, treprostinil diethanolamine, troglitazone, troxacitabine; Valdecoxib, valganciclovir hydrochloride, vandetanib, vardenafil hydrochloride hydrate, VAS-991, veglin, vinflunine, voriconazole; White sweet potato extract; Ximelagatran.

Clinical Trials as Topic↗

PubMed2005

Management of Staphylococcus aureus infections.

Because of high incidence, morbidity, and antimicrobial resistance, Staphylococcus aureus infections are a growing concern for family physicians. Strains of S. aureus that are resistant to vancomycin are now recognized. Increasing incidence of unrecognized community-acquired methicillin-resistant S. aureus infections pose a high risk for morbidity and mortality. Although the incidence of complex S. aureus infections is rising, new antimicrobial agents, including daptomycin and linezolid, are available as treatment. S. aureus is a common pathogen in skin, soft-tissue, catheter-related, bone, joint, pulmonary, and central nervous system infections. S. aureus bacteremias are particularly problematic because of the high incidence of associated complicated infections, including infective endocarditis. Adherence to precautions recommended by the Centers for Disease Control and Prevention, especially handwashing, is suboptimal.

Anti-Bacterial Agents↗

PubMed1989

Influence of antibiotics on motility and adherence of human neutrophils studied in vitro.

The influence of 14 antibiotics on chemotaxis, motility and adherence of human neutrophils has been studied. Neutrophils were preincubated for 30 min at 37 degrees C with the antibiotics. Chemotaxis was studied in antibiotic-free and antibiotic-containing agar using zymosan-activated serum and fMLP as stimuli. Adherence was studied in plastic microtitre plates. Most of the antibiotics studied did not affect the three functions studied. Daptomycin occasionally decreased random migration without affecting chemotaxis and adherence. Chemotaxis was occasionally modified by some of the quinolones, although this depended on the volunteer tested. The level of inhibition could be significant in diseased patients.

Anti-Bacterial Agents↗

PubMed1995

[Antimicrobial activity in Staphylococcus epidermidis biofilms on polyvinyl chloride catheters].

OBJECTIVES: We have evaluated the effect of polyvinylchloride (PVC) catheters on the activity of eight antimicrobials. Secondly the activity of these antimicrobials against Staphylococcus epidermidis biofilms on PVC catheters was also studied. METHOD: The MIC and MBC values of amikacine, clindamycine, cloxacilline, ciprofloxacine, vancomycine, teicoplanine, daptomycine and rifampicine was evaluated by a microdilution assay in the presence of 0.5 cm length segments of PVC catheters. Catheter segments with bacteria attached for different periods of time were used as inocula for the studies of antimicrobial activity against bacterial biofilms. Both slime producing and non-producing strains were evaluated. RESULTS: The presence of PVC did not affect the activity of the antimicrobials evaluated against S. epidermidis. For the non-slime producing strains MBC values against sessile bacteria were significantly higher than those against planktonic bacteria. For the slime-producing strain MBCs of ciprofloxacine, amikacine and teicoplanine against both bacterial populations were similar. At high concentrations (16 x MBC), clindamycine was the only antimicrobial that sterilized non-slime producing S. epidermidis biofilms on PVC. Against the slime producing strains ciprofloxacine yielded the highest reduction on bacterial viability (99.9%). CONCLUSIONS: S. epidermidis biofilms on PVC were more resistant to antimicrobials than planktonic bacteria. Slime production is not the only factor involved in this phenomenon.

Anti-Bacterial Agents↗