1. Proposed Pharmacokinetic-Pharmacodynamic Breakpoint of Garenoxacin and Other Quinolones
- Author
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Tatsuya Shibata, Yuka Yamagishi, Hiroshige Mikamo, Satoshi Nakagawa, Junichi Mitsuyama, and Nobuhiko Nomura
- Subjects
0301 basic medicine ,Microbiology (medical) ,Sitafloxacin ,030106 microbiology ,Administration, Oral ,Microbial Sensitivity Tests ,Pharmacology ,Quinolones ,medicine.disease_cause ,Garenoxacin ,Haemophilus influenzae ,03 medical and health sciences ,Minimum inhibitory concentration ,chemistry.chemical_compound ,0302 clinical medicine ,Levofloxacin ,Moxifloxacin ,Streptococcus pneumoniae ,medicine ,Pneumonia, Bacterial ,Humans ,030212 general & internal medicine ,Chemistry ,Area under the curve ,General Medicine ,Anti-Bacterial Agents ,Community-Acquired Infections ,Infectious Diseases ,Area Under Curve ,Monte Carlo Method ,medicine.drug ,Fluoroquinolones - Abstract
The pharmacokinetic-pharmacodynamic (PK-PD) breakpoints (BPs) of garenoxacin (GRNX) and other oral quinolones were calculated using Monte Carlo simulation (MCS) based on the distribution of changes in their plasma concentrations. PK-PD BPs of 400 mg once a day (QD) of GRNX for the free area under the curve/minimum inhibitory concentration (fAUC/MIC) for 30 strains of Streptococcus pneumoniae and 100 strains of gram-negative bacteria (G [-]) were 0.5 and 0.125 μg/mL, respectively. PK-PD BPs of other quinolones for S. pneumoniae/G (-) were 1/0.25 μg/mL for levofloxacin (LVFX) 500 mg QD, 0.5/0.125 μg/mL for moxifloxacin (MFLX) 400 mg QD, 0.0625/0.0156 μg/mL for sitafloxacin (STFX) 50 mg twice a day (BID) (100 mg QD), and 0.125/0.0313 μg/mL for STFX 100 mg BID. We also investigated the hypothetical probability of target attainments (PTAs) of fAUC/MIC for community-acquired pneumonia (CAP) using MCS, in consideration of the isolation frequencies of the three main causative pathogens of CAP: S. pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. For hypothetical CAP in adults, PTA of fAUC/MIC was 100% with GRNX and MFLX, 96%-97% with STFX at 100 mg BID, 45%-46% with LVFX, and 53%-58% with STFX at 100 mg QD and 50 mg BID. Based on the PK-PD BP, GRNX showed higher fAUC/MIC than the other quinolones tested against the three main pathogens of respiratory infections.
- Published
- 2017