Abstract
Multiple antibiotic strategies have been used in attempts to eradicate GBS from colonized infants and women. However, no chemoprophylactic regimen has been successful in reliably eliminating GBS carriage. Because rifampin (Rif) has been utilized successfully to terminate nasopharyngeal colonization with meningococci, H. influenzae, or S. pyogenes, we tested the in vitro sensitivity of GBS to Rif and the ability of Rif to eliminate GBS from nasally colonized infant rats. The MIC of Rif for 18 strains of type III GBS ranged from 0.1-0.4 μg/ml. Atraumatic nasal inoculation of 1-2 day-old rats with 107-108 colony forming units of GBS (MIC = 0.1 μg/ml) twice daily for 4 days resulted in 100% GBS carriage for at least 7 days. Colonized animals were divided into 4 treatment groups: 1) saline, 2) oral Rif (20 mg/kg/dose q 12 hrs × 4 days), 3) intraperitoneal (IP) penicillin (PCN) (50,000 units/kg/dose q 12 hrs × 4 days), or 4) IP PCN & oral Rif. All 73 saline controls and 26/29 PCN-treated animals had continued GBS nasal carriage 36 hours after completion of therapy (p=NS). In contrast, only 10/37 Rif-treated animals and 5/42 PCN & Rif-treated animals remained GBS-positive. No rifampin-resistant GBS emerged. Rif or PCN & Rif is significantly more effective in eradicating GBS carriage, compared to saline or PCN (p<0.0001). These data demonstrate that, unlike PCN, Rif (with or without PCN) is effective in eliminating GBS from nasally colonized infant rats. Clinical trials with rifampin appear indicated.
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Millard, D., Shulman, S. & Yogev, R. RIFAMPIN AND PENICILLIN THERAPY FOR ELIMINATING NASAL COLONIZATION OF TYPE III GROUP B STREPTOCOCCI (GBS) IN INFANT RATS. Pediatr Res 18 (Suppl 4), 335 (1984). https://doi.org/10.1203/00006450-198404001-01455
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DOI: https://doi.org/10.1203/00006450-198404001-01455