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Comparison of pharmacodynamics of azithromycin and erythromycin in vitro and in vivo
- Source :
- Antimicrobial Agents & Chemotherapy, 42(2), 377-382. American Society for Microbiology
- Publication Year :
- 1998
-
Abstract
- In this study, we determined the efficacy of various dosing regimens for erythromycin and azithromycin against four pneumococci with different susceptibilities to penicillin in an in vitro pharmacokinetic model and in a mouse peritonitis model. The MIC was 0.03 μg/ml, and the 50% effective doses (determined after one dose) of both drugs were comparable for the four pneumococcal strains and were in the range of 1.83 to 6.22 mg/kg. Dosing experiments with mice, using regimens for azithromycin of one to eight doses/6 h, showed the one-dose regimen to give the best result; of the pharmacodynamic parameters tested (the maximum drug concentration in serum [ C max ], the times that the drug concentration in serum remained above the MIC and above the concentration required for maximum killing, and the area under the concentration time curve), C max was the best predictor of outcome. The bacterial counts in mouse blood or peritoneal fluid during the first 24 h after challenge were not correlated to survival of the mice. The serum concentration profiles obtained with mice for the different dosing regimens were simulated in the in vitro pharmacokinetic model. Here as well, the one-dose regimen of azithromycin showed the best result. However, the killing curves in vivo in mouse blood and peritoneal fluid and in the vitro pharmacokinetic model were not similar. The in vitro killing curves showed a decrease of 2 log 10 within 2 and 3 h for azithromycin and erythromycin, respectively, whereas the in vivo killing curves showed a bacteriostatic effect for both drugs. It is concluded that the results in terms of predictive pharmacodynamic parameters are comparable for the in vitro and in vivo models and that high initial concentrations of azithromycin favor a good outcome.
- Subjects :
- Cmax
Azithromycin
Peritonitis
Pharmacology
Mice
Minimum inhibitory concentration
Pharmacokinetics
In vivo
Animals
Medicine
Experimental Therapeutics
Pharmacology (medical)
Antibacterial agent
business.industry
Pneumonia, Pneumococcal
Anti-Bacterial Agents
Erythromycin
Bioavailability
Disease Models, Animal
Streptococcus pneumoniae
Infectious Diseases
Pharmacodynamics
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 00664804
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Agents & Chemotherapy, 42(2), 377-382. American Society for Microbiology
- Accession number :
- edsair.doi.dedup.....ac1c4f51329d4c0d40a767413a7fc23e