Comparative Efficacy of Topical Versus Systemic Teicoplanin in Experimental Model of Wound Infections

• Published in: The Journal of surgical research Vol. 144; no. 1; pp. 74 - 81
• Main Authors: Ghiselli, Roberto, M.D, Cirioni, Oscar, M.D, Giacometti, Andrea, M.D, Scalise, Alessandro, M.D, Simonetti, Oriana, M.D, Mocchegiani, Federico, M.D, Orlando, Fiorenza, Ph.D, Goteri, Gaia, M.D, della Vittoria, Agnese, M.D, Filosa, Alessandra, Ph.D, Silvestri, Carmela, Ph.D, Offidani, Annamaria, M.D, Bertani, Aldo, M.D, Scalise, Giorgio, M.D, Saba, Vittorio, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2008; Elsevier
• Subjects: Administration, Topical; Animals; Anti-Bacterial Agents - blood; Anti-Bacterial Agents - pharmacology; Bacterial diseases; Biological and medical sciences; Disease Models, Animal; General aspects; Human bacterial diseases; hydro cellular foam; Infectious diseases; Injections, Intraperitoneal; Injections, Intravenous; Male; Medical sciences; Methicillin Resistance; Mice; Mice, Inbred BALB C; Microcirculation; Skin - blood supply; Skin - microbiology; Skin - pathology; Staphylococcal Infections - drug therapy; Staphylococcal Infections - pathology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus; Surgery; Surgical Wound Infection - drug therapy; Surgical Wound Infection - pathology; teicoplanin; Teicoplanin - blood; Teicoplanin - pharmacology; Vascular Endothelial Growth Factor A - blood; wounds; teicoplanin; wounds; hydro cellular foam; Staphylococcus aureus; Peptides; Systemic; Wound; Teicoplanin; Local administration; Glycopeptide; Surgery; Bacteria; Micrococcales; Micrococcaceae; Disseminated; Cell; Treatment efficiency; Experimental study; Infection; Medicine; Antibiotic; Treatment; Polypeptide; Bacteriosis; Models; Antibacterial agent; Staphylococcal infection; Comparative study
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2007.02.051

Introduction Surgical site infections are the second most common cause of nosocomial infections and, typically, gram-positive pathogens are involved. Materials and methods A mouse model was used to investigate the efficacy of different methods for the treatment of wound infections. A full thickness wound was established on the back subcutaneous tissue of adult male BALB/c mice. A small gauze was placed over each wound and then inoculated with 5 × 107 colony-forming units of Staphylococcus aureus . The study included a control group that did not receive any treatment and four contaminated groups treated, respectively, with: (1) drug-free Allevyn (Smith and Nephew Healthcare, Yorkshire, United Kingdom), (2) teicoplanin-soaked Allevyn, (3) drug-free Allevyn and daily intraperitoneal teicoplanin (7 mg/kg) and, finally, (4) teicoplanin-soaked Allevyn and daily intraperitoneal teicoplanin (7 mg/kg). Main outcome measures were quantitative bacterial culture, assessment of vascular endothelial growth factor (VEGF) plasma levels, histological examination with assessment of microvessel density, and of VEGF expression in tissue sections. Results Data analysis showed that strong inhibition of bacterial growth was achieved in any group treated with intraperitoneal teicoplanin. However, the highest inhibition of bacterial growth was obtained in the group that received teicoplanin-soaked Allevyn and intraperitoneal teicoplanin. Histological examination showed that each treatment modality was able to reduce the delay in wound repair. The most effective treatment appeared to be the local application of teicoplanin-soaked hydro gel foam. The tissue effects were associated with an increase in neovascularization and VEGF expression by endothelial cells and fibroblasts in the granulation tissue. Bacterial colonies also were reduced, especially when teicoplanin was given parenterally. Conclusions Soaking a hydro cellular foam with an antistaphylococcal agents, such as teicoplanin, may be useful for the management of infected wounds.