Data di Pubblicazione:
2005
Citazione:
Pharmacodynamics of levofloxacin in patients with acute exacerbation of chronic bronchitis / M. Cazzola, M.G. Matera,
G. Donnarumma, M.A. Tufano,
A. Sanduzzi, F. Marchetti, F. Blasi. - In: CHEST. - ISSN 0012-3692. - 128:4(2005), pp. 2093-2098.
Abstract:
Study objectives: Levofloxacin is a fluoroquinolone antimicrobial agent for which pharmacodynamic
relationships between the maximum serum antibiotic concentration (Cmax)/minimum
inhibitory concentration (MIC) ratio and/or the area under the serum concentration-time curve
during a 24-h dosing period (AUC0–24)/MIC ratio and clinical and/or microbiological outcomes
have been developed. In this study we examined the relationship between the in vitro bacterial
susceptibility to levofloxacin, the achieved levofloxacin serum and sputum concentrations, and
the in vivo bacterial eradication in patients with acute exacerbations of chronic bronchitis.
Patients and interventions: Thirty patients received levofloxacin, 500 mg/d po for 7 days. Samples
of venous blood and sputum for the determination of levofloxacin concentrations were collected
on day 1 immediately prior to dosing, and then at 1, 4, 8, 12, and 24 h.
Results: The mean peak concentration in serum (6.5 mg/L) was found 1 h after administration, and
at 4 h after administration in sputum (5.1 mg/L). Levofloxacin was always detectable 24 h after
administration from both samples. Successful treatment occurred in 90% (27 of 30 patients) when
assessed both clinically and bacteriologically. Treatment was successful in eight patients when the
AUC0–24/MIC ratio was > 40 for serum, and in nine patients when it was > 30 for sputum. Treatment
was also successful in seven patients when the Cmax/MIC ratio was > 5.01 for serum, and in nine
patients when the Cmax/MIC ratio was > 4.01 for sputum. Treatment was successful in 90% (27 of 30
patients) when the AUC0–24/MIC ratio was > 125 for serum and > 100 for sputum, and when
Cmax/MIC was > 10.01 for serum and > 8.01 for sputum following the first dose.
Conclusions: The pharmacodynamics values that we have obtained in sputum with levofloxacin may
be used as predictors of therapy outcomes.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Acute exacerbations of chronic bronchitis; Levofloxacin; Pharmacodynamics; Pharmacokinetics
Elenco autori:
M. Cazzola, M.G. Matera,
G. Donnarumma, M.A. Tufano,
A. Sanduzzi, F. Marchetti, F. Blasi
Link alla scheda completa: