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Moxifloxacin Popula...
Moxifloxacin Population Pharmacokinetics and Model-Based Comparison of Efficacy between Moxifloxacin and Ofloxacin in African Patients
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Zvada, Simbarashe P. (författare)
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Denti, Paolo (författare)
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Sirgel, Frederick A. (författare)
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Chigutsa, Emmanuel (författare)
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Hatherill, Mark (författare)
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Charalambous, Salome (författare)
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Mungofa, Stanley (författare)
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Wiesner, Lubbe (författare)
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- Simonsson, Ulrika S. H. (författare)
- Uppsala universitet,Institutionen för farmaceutisk biovetenskap,farmakometri
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Jindani, Amina (författare)
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Harrison, Thomas (författare)
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McIlleron, Helen M. (författare)
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(creator_code:org_t)
- 2014
- 2014
- Engelska.
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Ingår i: Antimicrobial Agents and Chemotherapy. - 0066-4804 .- 1098-6596. ; 58:1, s. 503-510
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Pharmacokinetic exposure and the MIC of fluoroquinolones are important determinants of their efficacy against Mycobacterium tuberculosis. Population modeling was used to describe the steady-state plasma pharmacokinetics of moxifloxacin in 241 tuberculosis (TB) patients in southern Africa. Monte Carlo simulations were applied to obtain the area under the unbound concentration-time curve from 0 to 24 h (fAUC(0-24)) after daily doses of 400 mg or 800 mg moxifloxacin and 800 mg ofloxacin. The MIC distributions of ofloxacin and moxifloxacin were determined for 197 drug-resistant clinical isolates of Mycobacterium tuberculosis. For a specific MIC, the probability of target attainment (PTA) was determined for target fAUC(0-24)/MIC ratios of >= 53 and >= 100. The PTAs were combined with the MIC distributions to calculate the cumulative fraction of response (CFR) for multidrug-resistant (MDR) Mycobacterium tuberculosis strains. Even with the less stringent target ratio of >= 53, moxifloxacin at 400 mg and ofloxacin at 800 mg achieved CFRs of only 84% and 58% for multidrug-resistant isolates with resistance to an injectable drug, while the 800-mg moxifloxacin dose achieved a CFR of 98%. Using a target ratio of >= 100 for multidrug-resistant strains (without resistance to injectable agents or fluoroquinolones), the CFR was 88% for moxifloxacin and only 43% for ofloxacin, and the higher dose of 800 mg moxifloxacin was needed to achieve a CFR target of >90%. Our results indicate that moxifloxacin is more efficacious than ofloxacin in the treatment of MDR-TB. Further studies should determine the optimal pharmacodynamic target for moxifloxacin in a multidrug regimen and clarify safety issues when it is administered at higher doses.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)
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Zvada, Simbarash ...
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Denti, Paolo
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Sirgel, Frederic ...
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Chigutsa, Emmanu ...
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Hatherill, Mark
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Charalambous, Sa ...
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visa fler...
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Mungofa, Stanley
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Wiesner, Lubbe
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Simonsson, Ulrik ...
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Jindani, Amina
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Harrison, Thomas
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McIlleron, Helen ...
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visa färre...
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Uppsala universitet