Wakefield T W, Schaberg D R, Pierson C L, Bouffard J A, Petry N A, Nolan K D, Spaulding S A, Whitehouse W M, Stanley J C
Surgery. 1987 Jul;102(1):8-14.
The efficacy of treating established vascular graft infections with rifampin and clindamycin (preferentially concentrated in leukocytes) and cefazolin (not concentrated in leukocytes) was studied in a canine model. Infrarenal aortic, 6 mm by 6 cm knitted Dacron double velour grafts were implanted and infected with 10(8) colony-forming units (CFU) of coagulase-positive Staphyloccus aureus organisms injected intravenously immediately after graft placement. Antibiotic therapy was instituted at 3 months postimplantation. Three groups were studied: (I) untreated controls (n = 3); (II) therapy with intravenous cefazolin 15 mg/kg/8 hr for 28 days (n = 7); and (III) combined therapy with intravenous rifampin 13 mg/kg/24 hr and intravenous clindamycin 13 mg/kg/8 hr for 28 days (n = 7). Grafts were removed for quantitative bacteriologic studies after the 28-day course of therapy. Two group I control grafts remained patent with 6.4 X 10(6) and 8.1 X 10(3) CFU S. aureus/gm of graft. The third control graft was thrombosed. Two group II animals demonstrated 1.6 X 10(7) and 2.3 X 10(5) CFU S. aureus organisms/gram of graft, respectively; the remaining five group II grafts were free of organisms. All group III grafts were sterile--a significant difference (p less than 0.05) from group I grafts. In this experimental model, established prosthetic graft infections were eradicated by intensive treatment with antibiotics preferentially concentrated in leukocytes.
在犬类模型中研究了利福平、克林霉素（优先集中在白细胞中）和头孢唑林（不集中在白细胞中）治疗已形成的血管移植物感染的疗效。植入6毫米×6厘米的肾下腹主动脉针织涤纶双绒毛移植物，并在移植物植入后立即静脉注射10⁸个凝固酶阳性金黄色葡萄球菌菌落形成单位（CFU）使其感染。在植入后3个月开始抗生素治疗。研究了三组：（I）未治疗的对照组（n = 3）；（II）静脉注射头孢唑林15毫克/千克/8小时，共28天（n = 7）；（III）静脉注射利福平13毫克/千克/24小时和静脉注射克林霉素13毫克/千克/8小时联合治疗28天（n = 7）。在28天的治疗疗程后取出移植物进行定量细菌学研究。I组的两个对照移植物保持通畅，每克移植物中有6.4×10⁶和8.1×10³CFU金黄色葡萄球菌。第三个对照移植物发生血栓形成。II组的两只动物每克移植物分别显示1.6×10⁷和2.3×10⁵CFU金黄色葡萄球菌；II组其余五个移植物无细菌。III组所有移植物均无菌——与I组移植物有显著差异（p＜0.05）。在这个实验模型中，通过优先集中在白细胞中的抗生素强化治疗可根除已形成的人工移植物感染。
