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Pharmacokinetics and pharmacodynamics of fluoroquinolones

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Presentation on theme: "Pharmacokinetics and pharmacodynamics of fluoroquinolones"— Presentation transcript:

1 Pharmacokinetics and pharmacodynamics of fluoroquinolones
George Drusano, Marie-Thérèse Labro, Otto Cars, Paul Mendes, Pramod Shah, Fritz Sörgel, Willi Weber  Clinical Microbiology and Infection  Volume 4, Pages 2S27-2S41 (April 1998) DOI: /j tb00692.x Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

2 Figure 1 Parameters of antibacterial bioactivity.
Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

3 Figure 2 Pharmacokinetic surrogate relationships. AUC = area under the serum concentration time curve; Cmax= maximum serum concentration; MIC = minimum inhibitory concentration; T>MIC = time that the serum concentration exceeds the MIC. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

4 Figure 3 Bactericidal activity of two enoxacin regimens against Klebsiella pneumoniae in a pharmacokinetic model. Cultures were eradicated in three of three experiments when the total daily dose was given as one single dose but in only two of three experiments when the same total daily dose was given as two equal doses [28]. Reproduced with permission from Antimicrobial Agents and Chemotherapy. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

5 Figure 4 Antibacterial effect of multiple-dose regimens of enoxacin and netilmicin against five organisms. Changes in bacterial numbers during treatment periods of 4 and 24 h are plotted against the ratios of peak concentration to MIC. t. = time [28]. Reproduced with permission from Antimicrobial Agents and Chemotherapy. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

6 Figure 5 Bactericidal activity of ciprofloxacin and subpopulation analysis of Pseudomonas aeruginosa 810 in an in vivo model following two simulated 200-mg doses. Values are mean ± SD [29]. Reproduced with permission from the American Journal of Medicine. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

7 Figure 6 Dose fractionation experiment 1. The MIC of lomefloxacin for the challenge organism was 1 mg/L. There were 50 animals evaluated per group [33]. Reproduced with permission from Antimicrobial Agents and Chemotherapy. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

8 Figure 7 Dose fractionation experiment 2. The MIC of lomefloxacin for the challenge organism was 1 mg/L. There were 20 animals evaluated per group [33]. Reproduced with permission from Antimicrobial Agents and Chemotherapy. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

9 Figure 8 Effect of altered MIC upon survivorship. Three isogenic organisms for which the lomefloxacin MICs were different served as the bacterial challenge. The three groups (MICs of 1, 4 and 8 mg/L) received 80 mg/kg every 24 h. A fourth group (O) had the strain for which the MIC was 1 mg/L used as the challenge organism and a dosing regimen of 20 mg/kg every 24 h. This provided the same peak MIC ratio as the challenge organism for which the MIC was 4 mg L used with animals treated with 80 mg/kg every 24 h. There were saline-treated controls for each challenge organism (all died). Twenty animals were evaluated [33]. Reproduced with permission from Antimicrobial Agents and Chemotherapy. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions

10 Figure 9 Time (days of therapy) to bacterial eradication versus AUIC (AUC/MIC ratio) illustrated by a time-to-event (survival) plot. Therapy versus the percentage of patients remaining culture positive on that day is shown. The three AUIC groups differed significantly (p < 0.005) [37]. Reproduced with permission from Antimicrobial Agents and Chemotherapy. Clinical Microbiology and Infection 1998 4, 2S27-2S41DOI: ( /j tb00692.x) Copyright © 1998 European Society of Clinical Infectious Diseases Terms and Conditions


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