Influence of adjunctive interferon-γ on treatment of gentamicin- and vancomycin-resistant Enterococcus faecalis infection in mice

Abstract

Increasing antibiotic resistance and the development of multidrug-resistance in the enterococci has complicated the treatment of serious enterococcal infections. It has been demonstrated in vitro that interferon-gamma (IFN-γ) significantly augments the activities of gentamicin and vancomycin against Enterococcus faecalis resistant to these antibiotics. The present study was aimed at determining whether this beneficial effect of IFN-γ on antienterococcal antibiotic activity can be validated in vivo. Following intraperitoneal inoculation in mice with a gentamicin- and vancomycin-resistant E. faecalis clinical isolate, the animals received IFN-γ, antibiotic or a combination of both agents, subcutaneously, at determined dosing regimens. Treatment with IFN-γ alone significantly improved survival of infected animals in a dose-dependent manner. High dose IFN-γ was not beneficial and the level of enterococcal infectious burden influenced the effectiveness of the cytokine. The addition of IFN-γ to therapy with gentamicin or vancomycin, or a combination of both antibiotics was associated with a marked increase in survival of infected non-neutropenic mice compared to treatments with the agents alone. However, the same treatments made in infected neutropenic mice did not show an enhancement effect by IFN-γ after a combination therapy with antibiotics. In a study to examine pharmacokinetic interactions, concurrent administration with IFN-γ significantly modified the disposition of gentamicin but not that of vancomycin. The results of this study suggest that the use of IFN-γ in combination with vancomycin or gentamicin is a new treatment option that might improve the outcome of therapy of multidrug-resistant E. faecalis infections.