Efficacy of #Ceftriaxone, Cefepime, #Doxycycline, #Ciprofloxacin, and Combination #Therapy for #Vibrio vulnificus #Foodborne #Septicemia (AAC, abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Efficacy of Ceftriaxone, Cefepime, Doxycycline, Ciprofloxacin, and Combination Therapy for Vibrio vulnificus Foodborne Septicemia

Sonya A. Trinh a, Hannah E. Gavin b and Karla J. F. Satchell b*

Author Affiliations: a Northwestern University Feinberg School of Medicine, Department of Medicine, Division of Infectious Diseases, 645 North Michigan Avenue, Suite 900, Chicago, Illinois, 60611, USA; b Northwestern University Feinberg School of Medicine, Department of Microbiology-Immunology, 303 East Chicago Avenue, Ward 6-225, Chicago, Illinois, 60611, USA



Vibrio vulnificus foodborne infections have higher rates of sepsis and mortality compared to wound infections; however, antibiotic efficacy studies have not been performed in foodborne infection models. The efficacy of ceftriaxone, cefepime, doxycycline, ciprofloxacin, and combination therapy was assessed in a V. vulnificus intestinal infection in mice to model foodborne infections. Consistent with prior studies of cefotaxime, cefepime was synergistic with doxycycline and ciprofloxacin in vitro; combination therapy significantly decreased bacterial growth by ≥2log10 compared to antibiotic monotherapy (p<0.01). In vivo, survival in the ceftriaxone (50%), doxycycline (79%), and ciprofloxacin (80%) groups were significantly higher than the control group (0%) (p<0.0001). Survival with ceftriaxone-doxycycline (91%) and ceftriaxone-ciprofloxacin (100%) therapy was significantly higher than with ceftriaxone (50%) (p≤0.05). Survival with cefepime-doxycycline (96%) and cefepime-ciprofloxacin (90%) therapy was significantly higher than with cefepime (20%) (p<0.001). There was no difference in survival between the combination therapy groups. Thus, we conclude that combination therapy was the most effective treatment for V. vulnificus foodborne septicemia. In a septic patient with a recent ingestion of raw seafood, cefepime in combination with doxycycline or ciprofloxacin should be initiated for coverage of resistant Gram-negative organisms and V. vulnificus while awaiting a microbiological diagnosis. Once a diagnosis of V. vulnificus foodborne septicemia is established, treatment can be safely transitioned to ceftriaxone in combination with doxycycline or ciprofloxacin.



*Corresponding Author: Karla J. F. Satchell, Northwestern University Feinberg School of Medicine, Department of Microbiology-Immunology, 303 East Chicago Avenue, Ward 6-205, Chicago, Illinois, 60611, USA, k-satchell@northwestern.edu

Copyright © 2017 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Vibrio Vulnificus; Ceftriaxone; Ciprofloxacin; Cefepime; Doxycycline.


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Giuseppe Michieli

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum (FluTrackers.com) in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.