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Bissantz C, Zampaloni C, David-Pierson P, Dieppois G, Guenther A, Trauner A, Winther L, Stubbings W. Translational PK/PD for the Development of Novel Antibiotics-A Drug Developer's Perspective. Antibiotics (Basel) 2024; 13:72. [PMID: 38247631 PMCID: PMC10812724 DOI: 10.3390/antibiotics13010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/23/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Antibiotic development traditionally involved large Phase 3 programs, preceded by Phase 2 studies. Recognizing the high unmet medical need for new antibiotics and, in some cases, challenges to conducting large clinical trials, regulators created a streamlined clinical development pathway in which a lean clinical efficacy dataset is complemented by nonclinical data as supportive evidence of efficacy. In this context, translational Pharmacokinetic/Pharmacodynamic (PK/PD) plays a key role and is a major contributor to a "robust" nonclinical package. The classical PK/PD index approach, proven successful for established classes of antibiotics, is at the core of recent antibiotic approvals and the current antibacterial PK/PD guidelines by regulators. Nevertheless, in the case of novel antibiotics with a novel Mechanism of Action (MoA), there is no prior experience with the PK/PD index approach as the basis for translating nonclinical efficacy to clinical outcome, and additional nonclinical studies and PK/PD analyses might be considered to increase confidence. In this review, we discuss the value and limitations of the classical PK/PD approach and present potential risk mitigation activities, including the introduction of a semi-mechanism-based PK/PD modeling approach. We propose a general nonclinical PK/PD package from which drug developers might choose the studies most relevant for each individual candidate in order to build up a "robust" nonclinical PK/PD understanding.
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Affiliation(s)
- Caterina Bissantz
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Claudia Zampaloni
- Roche Pharma Research and Early Development, Cardiovascular, Metabolism, Immunology, Infectious Diseases and Ophthalmology (CMI2O), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Pascale David-Pierson
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Guennaelle Dieppois
- Roche Pharma Research and Early Development, Cardiovascular, Metabolism, Immunology, Infectious Diseases and Ophthalmology (CMI2O), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Andreas Guenther
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Andrej Trauner
- Roche Pharma Research and Early Development, Cardiovascular, Metabolism, Immunology, Infectious Diseases and Ophthalmology (CMI2O), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Lotte Winther
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - William Stubbings
- Product Development, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
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2
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Sánchez-León I, Pérez-Nadales E, Marín-Sanz JA, García-Martínez T, Martínez-Martínez L. Heteroresistance to colistin in wild-type Klebsiella pneumoniae isolates from clinical origin. Microbiol Spectr 2023; 11:e0223823. [PMID: 37962370 PMCID: PMC10714954 DOI: 10.1128/spectrum.02238-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023] Open
Abstract
IMPORTANCE Colistin is one of the last remaining therapeutic options for dealing with Enterobacteriaceae. Unfortunately, heteroresistance to colistin is also rapidly increasing. We described the prevalence of colistin heteroresistance in a variety of wild-type strains of Klebsiella pneumoniae and the evolution of these strains with colistin heteroresistance to a resistant phenotype after colistin exposure and withdrawal. Resistant mutants were characterized at the molecular level, and numerous mutations in genes related to lipopolysaccharide formation were observed. In colistin-treated patients, the evolution of K. pneumoniae heteroresistance to resistance phenotype could lead to higher rates of therapeutic failure.
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Affiliation(s)
- Irene Sánchez-León
- Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Agricultural Chemistry, Edaphology and Microbiology, University of Cordoba, Cordoba, Spain
| | - Elena Pérez-Nadales
- Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Agricultural Chemistry, Edaphology and Microbiology, University of Cordoba, Cordoba, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Antonio Marín-Sanz
- Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Computer Sciences, University of Cordoba, Cordoba, Spain
| | - Teresa García-Martínez
- Department of Agricultural Chemistry, Edaphology and Microbiology, University of Cordoba, Cordoba, Spain
| | - Luis Martínez-Martínez
- Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Agricultural Chemistry, Edaphology and Microbiology, University of Cordoba, Cordoba, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Clinical Unit of Microbiology, Reina Sofía University Hospital, Cordoba, Spain
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3
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A new PKPD model to characterize the inoculum effect of Acinetobacter baumannii on polymyxin B in vitro. Antimicrob Agents Chemother 2021; 66:e0178921. [PMID: 34780268 DOI: 10.1128/aac.01789-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The inoculum effect (i.e., reduction in antimicrobial activity at large starting inoculum) is a phenomenon described for various pathogens. Since limited data exist regarding inoculum effect of Acinetobacter baumannii, we evaluated killing of A. baumannii by polymyxin B, a last-resort antibiotic, at several starting inocula and developed a PKPD model to capture this phenomenon. In vitro static time-kill experiments were performed using polymyxin B at concentrations ranging from 0.125 to 128 mg/L against a clinical A. baumannii isolate at four starting inocula from 105 to 108 CFU/mL. Samples were collected up to 30 h to quantify the viable bacterial burden and were simultaneously modeled in the NONMEM software program. The expression of polymyxin B resistance genes (lpxACD, pmrCAB and wzc), and genetic modifications were studied by RT-qPCR and DNA sequencing experiments, respectively. The PKPD model included a single homogeneous bacterial population with adaptive resistance. Polymyxin B effect was modelled as a sigmoidal Emax model and the inoculum effect as an increase of polymyxin B EC50 with increasing starting inoculum using a power function. Polymyxin B displayed a reduced activity as the starting inoculum increased: a 20-fold increase of polymyxin B EC50 was observed between the lowest and the highest inoculum. No effects of polymyxin B and inoculum size were observed on the studied genes. The proposed PKPD model successfully described and predicted the pronounced in vitro inoculum effect of A. baumannii on polymyxin B activity. These results should be further validated using other bacteria/antibiotic combinations and in vivo models.
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4
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Vallé Q, Roques BB, Bousquet-Mélou A, Dahlhaus D, Ramon-Portugal F, Dupouy V, Bibbal D, Ferran AA. Prediction of Minocycline Activity in the Gut From a Pig Preclinical Model Using a Pharmacokinetic -Pharmacodynamic Approach. Front Microbiol 2021; 12:671376. [PMID: 34305836 PMCID: PMC8299485 DOI: 10.3389/fmicb.2021.671376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
The increase of multidrug-resistant (MDR) bacteria has renewed interest in old antibiotics, such as minocycline, that can be active against various MDR Gram-negative pathogens. The elimination of minocycline by both kidneys and liver makes it suitable for impaired renal function patients. However, the drawback is the possible elimination of a high amount of drug in the intestines, with potential impact on the digestive microbiota during treatment. This study aimed to predict the potential activity of minocycline against Enterobacterales in the gut after parenteral administration, by combining in vivo and in vitro studies. Total minocycline concentrations were determined by UPLC-UV in the plasma and intestinal content of piglets following intravenous administration. In parallel, the in vitro activity of minocycline was assessed against two Escherichia coli strains in sterilized intestinal contents, and compared to activity in a standard broth. We found that minocycline concentrations were 6–39 times higher in intestinal contents than plasma. Furthermore, minocycline was 5- to 245-fold less active in large intestine content than in a standard broth. Using this PK-PD approach, we propose a preclinical pig model describing the link between systemic and gut exposure to minocycline, and exploring its activity against intestinal Enterobacterales by taking into account the impact of intestinal contents.
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Affiliation(s)
- Quentin Vallé
- INTHERES, Université de Toulouse, INRAE, ENVT, Toulouse, France.,Virbac, Carros, France
| | | | | | - David Dahlhaus
- INTHERES, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | | | | | - Delphine Bibbal
- INTHERES, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - Aude A Ferran
- INTHERES, Université de Toulouse, INRAE, ENVT, Toulouse, France
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5
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Acosta MM, Bram JT, Sim D, Read AF. Effect of drug dose and timing of treatment on the emergence of drug resistance in vivo in a malaria model. Evol Med Public Health 2020; 2020:196-210. [PMID: 33209305 PMCID: PMC7652304 DOI: 10.1093/emph/eoaa016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 05/15/2020] [Accepted: 05/26/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is a significant interest in identifying clinically effective drug treatment regimens that minimize the de novo evolution of antimicrobial resistance in pathogen populations. However, in vivo studies that vary treatment regimens and directly measure drug resistance evolution are rare. Here, we experimentally investigate the role of drug dose and treatment timing on resistance evolution in an animal model. METHODOLOGY In a series of experiments, we measured the emergence of atovaquone-resistant mutants of Plasmodium chabaudi in laboratory mice, as a function of dose or timing of treatment (day post-infection) with the antimalarial drug atovaquone. RESULTS The likelihood of high-level resistance emergence increased with atovaquone dose. When varying the timing of treatment, treating either very early or late in infection reduced the risk of resistance. When we varied starting inoculum, resistance was more likely at intermediate inoculum sizes, which correlated with the largest population sizes at time of treatment. CONCLUSIONS AND IMPLICATIONS (i) Higher doses do not always minimize resistance emergence and can promote the emergence of high-level resistance. (ii) Altering treatment timing affects the risk of resistance emergence, likely due to the size of the population at the time of treatment, although we did not test the effect of immunity whose influence may have been important in the case of late treatment. (iii) Finding the 'right' dose and 'right' time to maximize clinical gains and limit resistance emergence can vary depending on biological context and was non-trivial even in our simplified experiments. LAY SUMMARY In a mouse model of malaria, higher drug doses led to increases in drug resistance. The timing of drug treatment also impacted resistance emergence, likely due to the size of the population at the time of treatment.
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Affiliation(s)
- Mónica M Acosta
- Department of Biology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA 16802, USA
| | - Joshua T Bram
- Department of Biology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA 16802, USA
| | - Derek Sim
- Department of Biology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA 16802, USA
| | - Andrew F Read
- Department of Biology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA 16802, USA
- Department of Entomology, Pennsylvania State University, University Park, PA 16802, USA
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Antibacterial activity of cyadox against Clostridium perfringens in broilers and a dosage regimen design based on pharmacokinetic-pharmacodynamic modeling. Microb Pathog 2020; 141:103981. [PMID: 31962185 DOI: 10.1016/j.micpath.2020.103981] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 12/29/2022]
Abstract
Necrotic enteritis is an intestinal disease caused by Clostridium perfringens (C. perfringens) that results in high economic losses to the poultry industry. The purpose of this study was to investigate the antibacterial activity of cyadox against C. perfringens and to formulate its dosage regimen based on pharmacokinetics/pharmacodynamics (PK/PD) modeling in broilers. The PK parameters of cyadox in ileum of healthy and infected broilers following oral administration at 30 mg/kg body weight (BW) were investigated and PD study the MIC, MBC, MPC, and PAE were determined. The time-killing curves were established in vitro and ex vivo to evaluate the antibacterial activity of cyadox against C. perfringens. The results revealed that the MIC of cyadox against C. perfringens was 1-16 μg/mL. After oral administration of cyadox, the peak concentration (Cmax), maximum concentration time (Tmax), and area under the concentration-time curve (AUC) in ileum content of broilers were 143.55-161.48 μg/mL, 1.08-1.25 h, and 359.51-405.69 μg h/mL respectively. After Integrating the in vivo PK and ex vivo PD data the AUC24h/MIC values needed for bacteriostatic, bactericidal and bacterial eradication were 27.71 h, 78.93 h, and 165.14 h, respectively. By model validation, the cure rate was 85.71%. In conclusion, a dosage regimen of 14.02 mg/kg repeated after every 12 h for 3-5days was expected to be therapeutically effective in broilers against C. perfringens with MIC ≤2 μg/mL.
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7
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Time inside the mutant selection window as a predictor of staphylococcal resistance to linezolid. J Antibiot (Tokyo) 2018; 71:514-521. [DOI: 10.1038/s41429-017-0016-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/24/2017] [Accepted: 12/03/2017] [Indexed: 11/09/2022]
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8
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Lhermie G, Toutain PL, El Garch F, Bousquet-Mélou A, Assié S. Implementing Precision Antimicrobial Therapy for the Treatment of Bovine Respiratory Disease: Current Limitations and Perspectives. Front Vet Sci 2017; 4:143. [PMID: 28900616 PMCID: PMC5581812 DOI: 10.3389/fvets.2017.00143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/16/2017] [Indexed: 11/13/2022] Open
Abstract
The therapeutic efficacy of an early treatment protocol with an infection-stage adjusted fluoroquinolone regimen was evaluated in a field study on young bulls (YBs) presenting signs of bovine respiratory disease (BRD). A total of 195 YB (Charolais, Limousin, and Rouge-des-Prés breeds) from 6 farms implementing or not prophylactic antimicrobial treatments (PROPHY or absence) were randomly assigned to 1 of 2 experiment groups based on time of detection of BRD and first-line marbofloxacin regimen, early adjusted dose [Early 2 (E2)] or late standard dose [Late 10 (L10)]. Each YB was administered orally a reticulo-rumen bolus, allowing continuous monitoring of ruminal temperature. In the E2 group, YB presenting early signs of BRD, i.e., an increase in ruminal temperature over 40.2°C and persisting more than 12 h, confirmed by a clinical examination showing no or mild signs of BRD, were given 2 mg/kg of marbofloxacin. In the L10 group, YBs presenting moderate or severe signs of BRD at visual inspection, confirmed at clinical examination, were given 10 mg/kg of marbofloxacin. If needed, YBs were given a relapse treatment. The YBs were followed for 30 days. The proportions of first and relapse treatments were calculated, as well as the therapeutic efficacy at day 10. In the E2 group, the first-line treatments’ proportion was significantly higher (P < 0.05), while the relapse treatments’ proportion tended to be higher (P = 0.08), than in the L10 group. Evolution of clinical scores (CSs) of diseased YB was followed for 10 days. In both groups, CS and rectal temperature decreased significantly 24 h after treatment (P < 0.05). Treatment incidences (TI) representing antimicrobial consumption assessed on used daily doses (UDD) were calculated. Antimicrobial consumption of marbofloxacin and relapse treatments were not significantly different between the groups. These values were strongly influenced by the recourse to a prophylactic antimicrobial treatment, accounting for more than 90% of the antimicrobial amount in the herds implementing prophylaxis. The higher number of treatments in the groups treated on the basis of ruminal temperature monitoring, the accuracy of the detection method, and the necessary conditions to implement precision antimicrobial therapy in the field are discussed in this article.
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Affiliation(s)
- Guillaume Lhermie
- Department of Population Medicine and Diagnostic Science, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Pierre-Louis Toutain
- INRA, UMR1331 TOXALIM, Toulouse, France.,Université de Toulouse, INPT, ENVT, EIP, UPS, Toulouse, France
| | | | - Alain Bousquet-Mélou
- INRA, UMR1331 TOXALIM, Toulouse, France.,Université de Toulouse, INPT, ENVT, EIP, UPS, Toulouse, France
| | - Sébastien Assié
- INRA, UMR1300 Biologie, Epidémiologie et Analyse de Risque en santé animale BioEpAR, Nantes, France
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9
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Vasseur MV, Lacroix MZ, Toutain PL, Bousquet-Melou A, Ferran AA. Infection-stage adjusted dose of beta-lactams for parsimonious and efficient antibiotic treatments: A Pasteurella multocida experimental pneumonia in mice. PLoS One 2017; 12:e0182863. [PMID: 28777819 PMCID: PMC5544235 DOI: 10.1371/journal.pone.0182863] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/25/2017] [Indexed: 11/18/2022] Open
Abstract
In this study, the impact of infection stage on clinically and microbiologically efficacious doses and on antibiotic consumption was assessed during a naturally evolving infectious disease, using an original mouse model of pulmonary infection produced by air-borne contamination. When Pasteurella multocida was administered as pathogenic agent to immunocompetent mice, 60% of the animals exhibited clinical symptoms of pneumonia 2 to 4 days after bacterial contamination of the lungs. Two beta-lactam antibiotics were evaluated: amoxicillin and cefquinome, a fourth generation cephalosporin developed for food animals. First, a pharmacokinetic study was performed in infected mice to determine the exposure to amoxicillin or cefquinome required to treat clinically affected animals, based on the targeted values of PK/PD indices for beta-lactams. We then confirmed that these doses resulted in a 100% clinical cure rate in animals exhibiting clinical signs of infection and harboring a high pathogenic inoculum. More interestingly, we also showed that the same 100% clinical cure could be obtained in our model with 10-fold lower doses in animals at pre-patent stages of infection i.e. when harboring a low pathogenic inoculum. At the group level, antimicrobial drug consumption was reduced by treating animals at an early stage of the infection course with a pre-patent tailored dose. These results suggest that early treatment with a dose suitably adjusted to the stage of infection might help to reduce both overall antibiotic consumption and resistance selection pressure in the animals and in the environment.
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Affiliation(s)
- Maleck V. Vasseur
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Marlene Z. Lacroix
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Pierre-Louis Toutain
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Alain Bousquet-Melou
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Aude A. Ferran
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
- * E-mail:
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10
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Li J, Xie S, Ahmed S, Wang F, Gu Y, Zhang C, Chai X, Wu Y, Cai J, Cheng G. Antimicrobial Activity and Resistance: Influencing Factors. Front Pharmacol 2017; 8:364. [PMID: 28659799 PMCID: PMC5468421 DOI: 10.3389/fphar.2017.00364] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/26/2017] [Indexed: 01/09/2023] Open
Abstract
Rational use of antibiotic is the key approach to improve the antibiotic performance and tackling of the antimicrobial resistance. The efficacy of antimicrobials are influenced by many factors: (1) bacterial status (susceptibility and resistance, tolerance, persistence, biofilm) and inoculum size; (2) antimicrobial concentrations [mutant selection window (MSW) and sub-inhibitory concentration]; (3) host factors (serum effect and impact on gut micro-biota). Additional understandings regarding the linkage between antimicrobial usages, bacterial status and host response offers us new insights and encourage the struggle for the designing of antimicrobial treatment regimens that reaching better clinical outcome and minimizing the emergence of resistance at the same time.
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Affiliation(s)
- Jun Li
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural UniversityWuhan, China.,National Reference Laboratory of Veterinary Drug Residues (HZAU) and MOA Key Laboratory for The Detection of Veterinary Drug Residues in Foods, Huazhong Agricultural UniversityWuhan, China
| | - Shuyu Xie
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural UniversityWuhan, China.,National Reference Laboratory of Veterinary Drug Residues (HZAU) and MOA Key Laboratory for The Detection of Veterinary Drug Residues in Foods, Huazhong Agricultural UniversityWuhan, China
| | - Saeed Ahmed
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural UniversityWuhan, China.,National Reference Laboratory of Veterinary Drug Residues (HZAU) and MOA Key Laboratory for The Detection of Veterinary Drug Residues in Foods, Huazhong Agricultural UniversityWuhan, China
| | - Funan Wang
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural UniversityWuhan, China.,National Reference Laboratory of Veterinary Drug Residues (HZAU) and MOA Key Laboratory for The Detection of Veterinary Drug Residues in Foods, Huazhong Agricultural UniversityWuhan, China
| | - Yufeng Gu
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural UniversityWuhan, China.,National Reference Laboratory of Veterinary Drug Residues (HZAU) and MOA Key Laboratory for The Detection of Veterinary Drug Residues in Foods, Huazhong Agricultural UniversityWuhan, China
| | - Chaonan Zhang
- Basic Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural UniversityWuhan, China
| | - Ximan Chai
- Basic Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural UniversityWuhan, China
| | - Yalan Wu
- Basic Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural UniversityWuhan, China
| | - Jinxia Cai
- Basic Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural UniversityWuhan, China
| | - Guyue Cheng
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural UniversityWuhan, China.,National Reference Laboratory of Veterinary Drug Residues (HZAU) and MOA Key Laboratory for The Detection of Veterinary Drug Residues in Foods, Huazhong Agricultural UniversityWuhan, China.,Basic Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural UniversityWuhan, China
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11
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Lees P, Illambas J, Potter TJ, Pelligand L, Rycroft A, Toutain PL. A large potentiation effect of serum on the in vitro
potency of tulathromycin against Mannheimia haemolytica
and Pasteurella multocida. J Vet Pharmacol Ther 2016; 40:419-428. [DOI: 10.1111/jvp.12372] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/14/2016] [Indexed: 12/01/2022]
Affiliation(s)
- P. Lees
- The Royal Veterinary College; Hatfield Herts UK
| | - J. Illambas
- The Royal Veterinary College; Hatfield Herts UK
| | | | | | - A. Rycroft
- The Royal Veterinary College; Hatfield Herts UK
| | - P.-L. Toutain
- UMR 1331 Toxalim INRA-INPT; École Nationale Vétérinaire de Toulouse; Toulouse France
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12
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Lhermie G, Ferran AA, Assié S, Cassard H, El Garch F, Schneider M, Woerhlé F, Pacalin D, Delverdier M, Bousquet-Mélou A, Meyer G. Impact of Timing and Dosage of a Fluoroquinolone Treatment on the Microbiological, Pathological, and Clinical Outcomes of Calves Challenged with Mannheimia haemolytica. Front Microbiol 2016; 7:237. [PMID: 26973615 PMCID: PMC4773444 DOI: 10.3389/fmicb.2016.00237] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/15/2016] [Indexed: 11/13/2022] Open
Abstract
The efficacy of an early and low inoculum-adjusted marbofloxacin treatment was evaluated on microbiological and clinical outcomes in calves infected with 4.107 CFU of Mannheimia haemolytica A1. Twenty-two calves were included based on their rectal temperature rise in the 10 h after challenge and allocated in four groups, receiving a single intramuscular injection of saline (CON), 2 mg/kg marbofloxacin 2–4 h after inclusion (early treatment, E2), 2 or 10 mg/kg marbofloxacin 35–39 h after inclusion (late treatments, L2, L10). In CON calves, M. haemolytica DNA loads in bronchoalveolar lavages continuously increased from inclusion to day 4, and were associated with persistent respiratory clinical signs and lung lesions. At times of early and late treatments, M. haemolytica loads ranged within 3.5–4 and 5.5–6 log10 DNA copies/mL, respectively. Early 2 mg/kg marbofloxacin treatment led to rapid and total elimination of bacteria in all calves. The late treatments induced a reduction of bacterial loads, but 3 of 6 L2 and 1 of 6 L10 calves were still positive for M. haemolytica at day 4. Except for CON calves, all animals exhibited clinical improvement within 24 h after treatment. However, early 2 mg/kg treatment was more efficacious to prevent pulmonary lesions, as indicated by the reduction of the extension and severity of gross lesions and by the histopathological scores. These results demonstrated for the first time that a reduced antibiotic regimen given at an early stage of the disease and targeting a low bacterial load could be efficacious in a natural bovine model of pneumonia.
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Affiliation(s)
- Guillaume Lhermie
- Vetoquinol Global Drug DevelopmentLure, France; Ecole Nationale Vétérinaire de Toulouse, Institut National Polytechnique de Toulouse, Université de ToulouseToulouse, France; LUNAM Université, Oniris, UMR BioEpARNantes, France
| | - Aude A Ferran
- Ecole Nationale Vétérinaire de Toulouse, Institut National Polytechnique de Toulouse, Université de ToulouseToulouse, France; Institut National de la Recherche Agronomique, UMR1331 ToxAlimToulouse, France
| | - Sébastien Assié
- LUNAM Université, Oniris, UMR BioEpARNantes, France; Institut National de la Recherche Agronomique, UMR1300 BioEpARNantes, France
| | - Hervé Cassard
- Ecole Nationale Vétérinaire de Toulouse, Institut National Polytechnique de Toulouse, Université de Toulouse Toulouse, France
| | | | | | | | - Diane Pacalin
- Ecole Nationale Vétérinaire de Toulouse, Institut National Polytechnique de Toulouse, Université de Toulouse Toulouse, France
| | - Maxence Delverdier
- Ecole Nationale Vétérinaire de Toulouse, Institut National Polytechnique de Toulouse, Université de ToulouseToulouse, France; Institut National de la Recherche Agronomique, UMR1225 IHAPToulouse, France
| | - Alain Bousquet-Mélou
- Ecole Nationale Vétérinaire de Toulouse, Institut National Polytechnique de Toulouse, Université de ToulouseToulouse, France; Institut National de la Recherche Agronomique, UMR1331 ToxAlimToulouse, France
| | - Gilles Meyer
- Ecole Nationale Vétérinaire de Toulouse, Institut National Polytechnique de Toulouse, Université de ToulouseToulouse, France; Institut National de la Recherche Agronomique, UMR1225 IHAPToulouse, France
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13
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Qu Y, Qiu Z, Cao C, Lu Y, Sun M, Liang C, Zeng Z. Pharmacokinetics/pharmacodynamics of marbofloxacin in a Pasteurella multocida serious murine lung infection model. BMC Vet Res 2015; 11:294. [PMID: 26631082 PMCID: PMC4668604 DOI: 10.1186/s12917-015-0608-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 11/24/2015] [Indexed: 12/03/2022] Open
Abstract
Background Marbofloxacin is a third-generation fluoroquinolone developed solely for veterinary medicine with a broad spectrum of antibacterial activity against some Gram-positive and most Gram-negative bacteria, including the bovine respiratory tract pathogen, Pasteurella multocida. The objective of our study was to elucidate the pharmacokinetics and pharmacodynamics of marbofloxacin in a Pasteurella multocida infected murine lung model, and to estimate the magnitudes of pharmacokinetics-pharmacodynamics parameters associated with various effects. Results The pharmacokinetic studies revealed marbofloxacin kinetics in infected mice were linear over a dose ranging from 1.25 to 10 mg/kg of body weight. The protein binding in the plasma of neutropenic infected mice was 29.77 %. The magnitudes of the ratio of the free-drug area under the concentration-time curve over 24 h to MIC (fAUC0-24h/MIC) associated with static effect, a 2 log10 reduction and a 3 log10 reduction of bacterial counts were 40.84, 139.34, and 278.08 h, respectively. Conclusions Based on the dose range study, marbofloxacin exhibited concentration-dependent killing and the fAUC/MIC was the PK/PD index that correlated best with efficacy (R2 = 83 %). On the basis of a bactericidal effect goal of fAUC0-24h/MIC of 278.08 h, if marbofloxacin is used for the treatment of P. multocida serious lung infection with an MIC90 of 0.12 μg/ml, the current dose (2 mg/kg) would fail to achieve a bactericidal effect. It would benefit from higher doses (4 ~ 6 mg/kg) than those commonly used in clinical practice. Electronic supplementary material The online version of this article (doi:10.1186/s12917-015-0608-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ying Qu
- National Reference Laboratory of Veterinary Drug Residues (SCAU), College of Veterinary Medicine, South China Agriculture University, Guangzhou, China.
| | - Zhenzhen Qiu
- National Reference Laboratory of Veterinary Drug Residues (SCAU), College of Veterinary Medicine, South China Agriculture University, Guangzhou, China.
| | - Changfu Cao
- National Reference Laboratory of Veterinary Drug Residues (SCAU), College of Veterinary Medicine, South China Agriculture University, Guangzhou, China.
| | - Yan Lu
- National Reference Laboratory of Veterinary Drug Residues (SCAU), College of Veterinary Medicine, South China Agriculture University, Guangzhou, China.
| | - Meizhen Sun
- National Reference Laboratory of Veterinary Drug Residues (SCAU), College of Veterinary Medicine, South China Agriculture University, Guangzhou, China.
| | - Chaoping Liang
- National Reference Laboratory of Veterinary Drug Residues (SCAU), College of Veterinary Medicine, South China Agriculture University, Guangzhou, China.
| | - Zhenling Zeng
- National Reference Laboratory of Veterinary Drug Residues (SCAU), College of Veterinary Medicine, South China Agriculture University, Guangzhou, China.
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14
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Lhermie G, El Garch F, Toutain PL, Ferran AA, Bousquet-Mélou A. Bacterial Species-Specific Activity of a Fluoroquinolone against Two Closely Related Pasteurellaceae with Similar MICs: Differential In Vitro Inoculum Effects and In Vivo Efficacies. PLoS One 2015; 10:e0141441. [PMID: 26506096 PMCID: PMC4624641 DOI: 10.1371/journal.pone.0141441] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 10/08/2015] [Indexed: 11/18/2022] Open
Abstract
We investigated the antimicrobial activity of a fluoroquinolone against two genetically close bacterial species belonging to the Pasteurellaceae family. Time-kill experiments were used to measure the in vitro activity of marbofloxacin against two strains of Mannheimia haemolytica and Pasteurella multocida with similar MICs. We observed that marbofloxacin was equally potent against 105 CFU/mL inocula M. haemolytica and P. multocida. However, an inoculum effect was observed with P. multocida, meaning that marbofloxacin activity was decreased against a 108 CFU/mL inoculum, whereas no inoculum effect was observed with M. haemolytica. Marbofloxacin activity was also tested in a lung infection model with immunocompromised mice intratracheally infected with 109 CFU of each bacteria. At the same dose, the clinical and bacteriological outcomes were much better for mice infected with M. haemolytica than for those infected with P. multocida. Moreover, bacteriological eradication was obtained with a lower marbofloxacin dose for mice infected with M. haemolytica. Our results suggest that the differential in vivo marbofloxacin efficacy observed with the two bacterial species of similar MIC could be explained by a differential inoculum effect. Consequently, MICs determined on 105 CFU inocula were not predictive of the differences in antibiotic efficacies against high bacterial inocula of closely related bacterial strains. These results could stimulate further investigations on bacterial species-specific antibiotic doses in a clinical setting.
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Affiliation(s)
| | | | - Pierre-Louis Toutain
- INRA, UMR1331 TOXALIM, Toulouse, France
- Université de Toulouse, INPT, ENVT, EIP, UPS, Toulouse, France
| | - Aude A. Ferran
- INRA, UMR1331 TOXALIM, Toulouse, France
- Université de Toulouse, INPT, ENVT, EIP, UPS, Toulouse, France
| | - Alain Bousquet-Mélou
- INRA, UMR1331 TOXALIM, Toulouse, France
- Université de Toulouse, INPT, ENVT, EIP, UPS, Toulouse, France
- * E-mail:
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15
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Toledo PVM, Tuon FF, Bail L, Manente F, Arruda P, Aranha-Junior AA. Experimental model for treatment of extended spectrum betalactamase producing-Klebsiella pneumoniae. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2015; 27:168-71. [PMID: 25184764 PMCID: PMC4676372 DOI: 10.1590/s0102-67202014000300002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/13/2014] [Indexed: 11/30/2022]
Abstract
Background Animal models are useful to evaluate the efficacy of antimicrobials in
experimental sepsis. Aim To elucidate the steps of producing an experimental model for the treatment of
extended-spectrum beta-lactamase (ESBL)-producing Klebsiella
pneumoniae sepsis Methods Several ESBL inoculums ranging from 1.5x109 colony-forming units per
milliliter (CFU/mL) to 2.0x1010CFU/mL were administered by peritoneal
injection in adults Wistar rats. Outcomes and microbiological data of quantitative
peritoneal and blood cultures were observed in untreated animals. Animals which
received 2.0x1010CFU/mL inoculums were treated with single meropenem
dose (30mg/kg) after one hour and those which received 1.0x1010CFU/mL
inoculums were treated immediately with three doses of meropenem 50 mg/kg.
Outcomes were observed for 24 hours after inoculation. Results Solutions with 1.5 x109 and 6.0x109 CFU/mL were not lethal
within 24 hours. Inoculums of 1.0x1010CFU/mL were lethal in 80% and
solutions with 2.0x1010 CFU/mL were lethal in 100% of animals. ESBL
lethal sepsis (1.0x1010CFU/mL) was treated immediately with 50 mg/kg of
meropenem every eight hours for 24 hours and presented 40% mortality compared with
80% mortality of the control group (p=0.033). Quantitative cultures of peritoneal
fluid presented 104CFU/mL or less for treated animals compared to more
than 105 for untreated animals (p=0.001). Conclusion Inoculums of 1.0x1010CFU/mL achieved the best results to study a model
of lethal sepsis and this model of treatment of carbapenem-susceptible
Enterobacteriaceae can serve as control to further evaluation
of treatment of carbapenemase-producing Enterobacteriaceae
models.
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Affiliation(s)
| | | | - Larissa Bail
- Department of Pharmacy and Biochemistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Francine Manente
- Department of Pharmacy and Biochemistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Polliane Arruda
- Department of Medicine, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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16
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Lees P, Pelligand L, Illambas J, Potter T, Lacroix M, Rycroft A, Toutain PL. Pharmacokinetic/pharmacodynamic integration and modelling of amoxicillin for the calf pathogens Mannheimia haemolytica and Pasteurella multocida. J Vet Pharmacol Ther 2015; 38:457-70. [PMID: 25669418 DOI: 10.1111/jvp.12207] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 01/07/2015] [Indexed: 11/29/2022]
Abstract
The antimicrobial properties of amoxicillin were determined for the bovine respiratory tract pathogens, Mannheima haemolytica and Pasteurella multocida. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time-kill curves were established. Pharmacokinetic (PK)/pharmacodynamic (PD) modelling of the time-kill data, based on the sigmoidal Emax equation, generated parameters for three levels of efficacy, namely bacteriostatic, bactericidal (3log10 reduction) and 4log10 reduction in bacterial counts. For these levels, mean AUC(0-24 h) /MIC serum values for M. haemolytica were 29.1, 57.3 and 71.5 h, respectively, and corresponding values for P. multocida were 28.1, 44.9 and 59.5 h. Amoxicillin PK was determined in calf serum, inflamed (exudate) and noninflamed (transudate) tissue cage fluids, after intramuscular administration of a depot formulation at a dosage of 15 mg/kg. Mean residence times were 16.5 (serum), 29.6 (exudate) and 29.0 h (transudate). Based on serum MICs, integration of in vivo PK and in vitro PD data established maximum concentration (Cmax )/MIC ratios of 13.9:1 and 25.2:1, area under concentration-time curve (AUC0-∞ )/MIC ratios of 179 and 325 h and T>MIC of 40.3 and 57.6 h for P. multocida and M. haemolytica, respectively. Monte Carlo simulations for a 90% target attainment rate predicted single dose to achieve bacteriostatic and bactericidal actions over 48 h of 17.7 and 28.3 mg/kg (M. haemolytica) and 17.7 and 34.9 mg/kg (P. multocida).
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Affiliation(s)
- P Lees
- The Royal Veterinary College, Hawkshead Campus, Hatfield, Herts, UK
| | - L Pelligand
- The Royal Veterinary College, Hawkshead Campus, Hatfield, Herts, UK
| | - J Illambas
- The Royal Veterinary College, Hawkshead Campus, Hatfield, Herts, UK
| | - T Potter
- The Royal Veterinary College, Hawkshead Campus, Hatfield, Herts, UK
| | - M Lacroix
- Ecole National Vétérinaire de Toulouse, UMR 1331 Toxalim INRA, Toulouse Cedex 03, France
| | - A Rycroft
- The Royal Veterinary College, Hawkshead Campus, Hatfield, Herts, UK
| | - P-L Toutain
- Ecole National Vétérinaire de Toulouse, UMR 1331 Toxalim INRA, Toulouse Cedex 03, France
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17
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Baroni EE, Rubio S, De Lucas JJ, Andrés MDS, Andrés MIS. Comparison of pharmacokinetics of marbofloxacin after subcutaneous administration of various multiple-dose regimens to water buffalo calves (Bubalus bubalis). Am J Vet Res 2014; 75:1049-55. [PMID: 25419804 DOI: 10.2460/ajvr.75.12.1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine pharmacokinetics of marbofloxacin in water buffalo calves (Bubalus bubalis) after multiple SC administrations and to assess differences in regimen efficacy. ANIMALS 18 healthy buffalo calves. PROCEDURES Calves (n = 6 calves/group) were assigned to receive marbofloxacin SC in the neck at 1 of 3 dosages (2 mg/kg, q 24 h for 6 days [regimen 1]; 4 mg/kg, q 48 h for 6 days [regimen 2]; and 4 mg/kg, q 24 h for 3 days [regimen 3]). Serum marbofloxacin concentrations were analyzed. Efficacy predictors were estimated on the basis of minimum inhibitory concentration and mutant prevention concentration reported for Pasteurella multocida and Mannheimia haemolytica. RESULTS Mean ± SD area under the concentration-time curve was 5.92 ± 0.40 μg•h/mL for regimen 1, which differed significantly from that for regimens 2 (14.26 ± 0.92 μg•h/mL) and 3 (14.17 ± 0.51 μg•h/mL). Mean residence time and mean elimination half-life for regimen 2 (9.93 ± 0.20 hours and 8.77 ± 0.71 hours) both differed significantly from those for regimens 1 (721 ± 0.11 hours and 5.71 ± 0.38 hours) and 3 (759 ± 0.13 hours and 737 ± 1.19 hours). Values obtained from indices for P multocida and M haemolytica had an excessively wide range because of the various degrees of antimicrobial susceptibility (low, medium, and high) of the strains. CONCLUSIONS AND CLINICAL RELEVANCE Regimen 3 had the most favorable indices, and it would be conducive for owner compliance and require less handling of animals.
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Affiliation(s)
- Eduardo E Baroni
- Department of Pharmacology, Faculty of Veterinary Science, Universidad Nacional del Litoral, 2805, Esperanza 3000, Santa Fe, Argentina
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18
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Firsov AA, Portnoy YA, Strukova EN, Shlykova DS, Zinner SH. Predicting bacterial resistance using the time inside the mutant selection window: Possibilities and limitations. Int J Antimicrob Agents 2014; 44:301-5. [DOI: 10.1016/j.ijantimicag.2014.06.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/26/2014] [Accepted: 06/08/2014] [Indexed: 11/15/2022]
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19
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Evaluation of meropenem regimens suppressing emergence of resistance in Acinetobacter baumannii with human simulated exposure in an in vitro intravenous-infusion hollow-fiber infection model. Antimicrob Agents Chemother 2014; 58:6773-81. [PMID: 25182633 DOI: 10.1128/aac.03505-14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The emergence of resistance to carbapenems in Pseudomonas aeruginosa can be suppressed by optimizing the administration of meropenem. However, whether the same is true for Acinetobacter baumannii is not fully understood. We assessed the bactericidal activity of meropenem and its potency to suppress the emergence of resistance in A. baumannii with human simulated exposure in an in vitro intravenous-infusion hollow-fiber infection model (HFIM). Two clinical strains of carbapenem-susceptible multidrug-resistant A. baumannii (CS-MDRAB), CSRA24 and CSRA91, were used, and their MICs and mutant prevention concentrations (MPCs) were determined. Six meropenem dosage regimens (0.5, 1.0, or 2.0 g given every 8 h [q8h] with a 0.5-h or 3-h infusion for seven consecutive days) were simulated and then evaluated in the HFIM. Both the total population and resistant subpopulations of the two strains were quantified. Drug concentrations were measured by high-performance liquid chromatography. All dosage regimens, except for the lowest dosage (0.5 g for both the 0.5-h and 3-h infusions), showed 3-log CFU/ml bacterial killing. Dosage regimens of 2.0 g with 0.5-h and 3-h infusions exhibited an obvious bactericidal effect and suppressed resistance. Selective amplification of subpopulations with reduced susceptibility to meropenem was suppressed with a percentage of the dosage interval in which meropenem concentrations exceeded the MPC (T>MPC) of ≥20% or with a ratio of T>MPC to the percentage of the dosage interval in which drug concentrations are within the mutant selection window of ≥0.25. Our in vitro data support the use of a high dosage of meropenem (2.0 g q8h) for the treatment of severe infection caused by CS-MDRAB.
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20
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Vilalta C, Giboin H, Schneider M, El Garch F, Fraile L. Pharmacokinetic/pharmacodynamic evaluation of marbofloxacin in the treatment of
Haemophilus parasuis
and
Actinobacillus pleuropneumoniae
infections in nursery and fattener pigs using Monte Carlo simulations. J Vet Pharmacol Ther 2014; 37:542-9. [DOI: 10.1111/jvp.12134] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 04/23/2014] [Indexed: 11/30/2022]
Affiliation(s)
- C. Vilalta
- Universitat Autònoma de Barcelona Cerdanyola del Vallès Spain
| | - H. Giboin
- Vétoquinol Research Centre Lure France
| | | | | | - L. Fraile
- ETSEA Universitat de Lleida Lleida Spain
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21
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Low or high doses of cefquinome targeting low or high bacterial inocula cure Klebsiella pneumoniae lung infections but differentially impact the levels of antibiotic resistance in fecal flora. Antimicrob Agents Chemother 2014; 58:1744-8. [PMID: 24395228 DOI: 10.1128/aac.02135-13] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The combination of efficacious treatment against bacterial infections and mitigation of antibiotic resistance amplification in gut microbiota is a major challenge for antimicrobial therapy in food-producing animals. In rats, we evaluated the impact of cefquinome, a fourth-generation cephalosporin, on both Klebsiella pneumoniae lung infection and intestinal flora harboring CTX-M-producing Enterobacteriaceae. Germfree rats received a fecal flora specimen from specific-pathogen-free pigs, to which a CTX-M-producing Escherichia coli strain had been added. K. pneumoniae cells were inoculated in the lungs of these gnotobiotic rats by using either a low (10(5) CFU) or a high (10(9) CFU) inoculum. Without treatment, all animals infected with the low or high K. pneumoniae inoculum developed pneumonia and died before 120 h postchallenge. In the treated groups, the low-inoculum rats received a 4-day treatment of 5 mg/kg of body weight cefquinome beginning at 24 h postchallenge (prepatent phase of the disease), and the high-inoculum rats received a 4-day treatment of 50 mg/kg cefquinome beginning when the animals expressed clinical signs of infection (patent phase of the disease). The dose of 50 mg/kg targeting the high K. pneumoniae inoculum cured all the treated rats and resulted in a massive amplification of CTX-M-producing Enterobacteriaceae. A dose of 5 mg/kg targeting the low K. pneumoniae inoculum cured all the rats and averted an outbreak of clinical disease, all without any amplification of CTX-M-producing Enterobacteriaceae. These findings might have implications for the development of new antimicrobial treatment strategies that ensure a cure for bacterial infections while avoiding the amplification of resistance genes of human concern in the gut microbiota of food-producing animals.
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22
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Balaje R, Sidhu P, Kaur G, Rampal S. Mutant prevention concentration and PK–PD relationships of enrofloxacin for Pasteurella multocida in buffalo calves. Res Vet Sci 2013; 95:1114-24. [DOI: 10.1016/j.rvsc.2013.07.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 07/15/2013] [Accepted: 07/16/2013] [Indexed: 12/01/2022]
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23
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Pharmacokinetic/pharmacodynamic assessment of the effects of parenteral administration of a fluoroquinolone on the intestinal microbiota: comparison of bactericidal activity at the gut versus the systemic level in a pig model. Int J Antimicrob Agents 2013; 42:429-35. [PMID: 24021905 DOI: 10.1016/j.ijantimicag.2013.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/09/2013] [Accepted: 07/16/2013] [Indexed: 11/21/2022]
Abstract
Classical pharmacokinetic/pharmacodynamic studies of antimicrobial agents performed by combining plasma concentrations and minimum inhibitory concentrations (MICs) are often predictive of the activity of a drug against targeted pathogens located at infectious sites closely connected to circulating blood. However, these studies do not predict the impact of parenteral antimicrobial treatment on intestinal bacteria, which could be responsible for transmission of resistance between species or in the environment. The aim of this study was to assess the differential antibacterial activity of a fluoroquinolone against lung and gut bacteria. Plasma and intestinal concentrations of marbofloxacin were assessed in pigs following intramuscular administration, and the in vitro relationship between marbofloxacin concentrations and mean bacterial inoculum growth in standard broth and in sterilised intestinal contents was modelled. It was shown that the increased intestinal exposure to marbofloxacin compared with plasma in pigs was compensated by reduced marbofloxacin activity against Escherichia coli in the contents of the digestive tract compared with in broth. These results showed that marbofloxacin doses used to target pathogens at the lung level would similarly affect the bacterial population of the same size and with a similar MIC located in the small intestine. However, it was shown that the bactericidal activity of marbofloxacin was increased 4- to 7-fold with low (10(5)CFU/mL) compared with high (10(8)CFU/mL) inoculum sizes. This result suggests that much lower marbofloxacin doses than those classically used would potentially eradicate low pulmonary pathogenic inocula while having a minimal impact on the large gut microbiota.
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24
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Illambas J, Potter T, Sidhu P, Rycroft AN, Cheng Z, Lees P. Pharmacodynamics of florfenicol for calf pneumonia pathogens. Vet Rec 2013; 172:340. [PMID: 23482237 DOI: 10.1136/vr.101155] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The antimicrobial properties of florfenicol were investigated for the bovine respiratory tract pathogens, Mannheimia haemolytica and Pasteurella multocida. Three in vitro indices of efficacy and potency were determined; minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and in vitro time-kill curves for six pathogenic strains of each organism. Each was monitored in two matrices, Mueller Hinton broth (MHB) and calf serum. MBC:MIC ratios were low, 1.8 : 1 for M haemolytica in both MHB and serum and 2.4 : 1 and 2.1 : 1 for P multocida in MHB and serum, respectively. The killing action of florfenicol had the characteristics of concentration dependency against M haemolytica and codependency (on time and concentration) against P multocida. Modelling of the time-kill data after 24 hours exposure was undertaken to quantify three levels of activity for the ratio, area under concentration-time curve over 24 hours (AUC24h)/MIC; bacteriostatic action (no change in bacterial count), 3log10 reduction and 4log10 reduction in bacterial count. Mean AUC24h/MIC values for P multocida in MHB (and serum) were 22.0 (23.3) hour, 34.5 (39.9) hour and 45.8 (50.4) hour, respectively. Similar numerical values were obtained for M haemolytica. For both bacterial species, interstrain variability was low; coefficients of variation ( per cent) in serum for 3log10 and 4log10 reductions in count were, respectively, 14.3 and 24.1 for P multocida and 7.8 and 11.4 for M haemolytica. These data form a rational basis for dosage selection for treatment of calf pneumonia caused by M haemolytica or P multocida.
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Affiliation(s)
- J Illambas
- Department of Comparative Biomedical Sciences, The Royal Veterinary College, Hawkshead Campus, Hatfield, Herts., AL9 7TA, UK
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25
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Illambas J, Potter T, Cheng Z, Rycroft A, Fishwick J, Lees P. Pharmacodynamics of marbofloxacin for calf pneumonia pathogens. Res Vet Sci 2013; 94:675-81. [PMID: 23375665 DOI: 10.1016/j.rvsc.2012.12.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 12/12/2012] [Accepted: 12/23/2012] [Indexed: 10/27/2022]
Abstract
The pharmacodynamic (PD) properties of the fluoroquinolone, marbofloxacin, were determined for the bovine respiratory tract pathogens Mannheima haemolytica and Pasteurella multocida. For six pathogenic isolates of each organism, three in vitro indices of efficacy and potency were determined, namely, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time-kill curves. Each parameter was determined in two matrices, Mueller Hinton Broth (MHB) and calf serum. For serum, MBC:MIC ratios were 2.7:1 (M. haemolytica) and 2.4:1 (P. multocida). The killing action of marbofloxacin had the characteristics of concentration dependency against M. haemolytica and co-dependency (on time and concentration) against P. multocida. To confirm the characteristics of the time-kill profiles, growth inhibition produced by marbofloxacin was also established ex vivo in three biological fluids, calf serum, exudate and transudate, harvested from a tissue cage model. The in vitro time-kill data were modelled with pharmacokinetic properties of marbofloxacin, established by intramuscular administration in calves at a dose of 2 mg/kg; three levels of activity, namely bacteriostatic, 3 log10 reduction and 4 log10 reduction in bacterial counts were determined. Mean AUC(24h)/MIC values (with percentage coefficients of variation indicating inter-isolate variability) for M. haemolytica, based on serum MICs, were 31.3 (41.6), 57.7 (42.4) and 79.2 (44.6) h, respectively. Corresponding values for MHB were 20.5 (58.0), 40.5 (51.8) and 51.2 (24.30) h, respectively. When allowance was made for binding of marbofloxacin to serum protein, the AUC(24h)/MIC values for serum were similar to those for MHB. Numerical AUC(24h)/MIC values for P. multocida were slightly lower than those obtained for M. haemolytica. These data establish for the first time inter-isolate variability in AUC(24h)/MIC values required for three levels of bacterial kill for two pathogenic species and thereby provide an indication of variability in serum concentration that might be required to achieve efficacy in clinical subjects.
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Affiliation(s)
- Joanna Illambas
- The Royal Veterinary College, Hawkshead Campus, Hatfield, Hertfordshire AL9 7TA, United Kingdom
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26
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Mitchell JD, McKellar QA, McKeever DJ. Evaluation of antimicrobial activity against Mycoplasma mycoides subsp. mycoides Small Colony using an in vitro dynamic dilution pharmacokinetic/pharmacodynamic model. J Med Microbiol 2012; 62:56-61. [PMID: 23002064 DOI: 10.1099/jmm.0.045971-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The objectives of this study were to assess the activity of oxytetracycline (OTC), danofloxacin and tulathromycin against Mycoplasma mycoides subsp. mycoides Small Colony, the causative agent of contagious bovine pleuropneumonia, in an in vitro dynamic concentration model and to determine the concentration and/or time dependence of such activity. Time-kill assays that simulated elimination of antimicrobials from the body were performed. Initial antimicrobial concentrations corresponded to various multiples of the MIC and cultures were diluted in a stepwise fashion with either drug-free or drug-containing artificial medium to mimic administration by single-release bolus or infusion, respectively. Where appropriate, data were fitted to sigmoidal E(max) models. OTC produced no change in mycoplasma titre from the initial inoculum size, regardless of the concentration or means of drug exposure. Both danofloxacin and tulathromycin resulted in a decrease in mycoplasma titre but neither was bactericidal (99.9 % kill) over 12 h. A greater antimycoplasmal effect, defined as the change in log(10) (c.f.u. ml(-1)) over 12 h, was achieved when danofloxacin was administered as a single-release bolus, suggesting concentration-dependent activity, whereas the antimycoplasmal effect of tulathromycin was comparable following administration by single-release bolus or infusion, owing to its long half-life.
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Affiliation(s)
- John D Mitchell
- Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | | | - Declan J McKeever
- Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
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Vallé M, Schneider M, Galland D, Giboin H, Woehrlé F. Pharmacokinetic and pharmacodynamic testing of marbofloxacin administered as a single injection for the treatment of bovine respiratory disease. J Vet Pharmacol Ther 2011; 35:519-28. [PMID: 22126438 DOI: 10.1111/j.1365-2885.2011.01350.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
New approaches in Pharmacokinetic/Pharmacodynamic (PK/PD) integration suggested that marbofloxacin, a fluoroquinolone already licensed for the treatment of bovine respiratory disease at a daily dosage of 2 mg/kg for 3-5 days, would be equally clinically effective at 10 mg/kg once (Forcyl(®)), whilst also reducing the risk of resistance. This marbofloxacin dosage regimen was studied using mutant prevention concentration (MPC), PK simulation, PK/PD integration and an in vitro dynamic system. This system simulated the concentration-time profile of marbofloxacin in bovine plasma established in vivo after a single 10 mg/kg intramuscular dose and killing curves of field isolated Pasteurellaceae strains of high (minimum inhibitory concentration (MIC) MIC ≤ 0.03 μg/mL), average (MIC of 0.12-0.25 μg/mL) and low (MIC of 1 μg/mL) susceptibility to marbofloxacin. The marbofloxacin MPC values were 2- to 4-fold the MIC values for all Mannheimia haemolytica, Pasteurella multocida tested. Marbofloxacin demonstrated a concentration-dependent killing profile with bactericidal activity observed within 1 h for most strains. No resistance development (MIC ≥ 4 μg/mL) was detected in the dynamic tests. Target values for risk of resistance PK/PD surrogates (area under the curve (AUC) AUC(24 h) /MPC and T(>MPC) /T(MSW) ratio) were achieved for all clinically susceptible pathogens. The new proposed dosing regimen was validated in vitro and by PK/PD integration confirming the single-injection short-acting antibiotic concept.
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Affiliation(s)
- M Vallé
- Le Petit Curtil, Sainte Bénigne, France
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Baroni EE, Rubio S, Rodríguez C, De Lucas JJ, Fernández H, Andrés MS. Pharmacokinetic interactions of marbofloxacin with anti-inflammatory drugs in buffalo calves. Vet Rec 2011; 169:182. [DOI: 10.1136/vr.d4012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- E. E. Baroni
- Cátedra de Farmacología y Toxicología; Facultad de Ciencias Veterinarias; Universidad Nacional del Litoral; 3080 Esperanza Santa Fe Argentina
| | - S. Rubio
- Departamento de Toxicología y Farmacología; Facultad de Veterinaria; Universidad Complutense de Madrid; 28040 Madrid Spain
| | - C. Rodríguez
- Departamento de Toxicología y Farmacología; Facultad de Veterinaria; Universidad Complutense de Madrid; 28040 Madrid Spain
| | - J. J. De Lucas
- Departamento de Toxicología y Farmacología; Facultad de Veterinaria; Universidad Complutense de Madrid; 28040 Madrid Spain
| | - H. Fernández
- Cátedra de Farmacología y Toxicología; Facultad de Ciencias Veterinarias; Universidad Nacional del Litoral; 3080 Esperanza Santa Fe Argentina
| | - M. S. Andrés
- Departamento de Toxicología y Farmacología; Facultad de Veterinaria; Universidad Complutense de Madrid; 28040 Madrid Spain
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Lüders C, Baroni EE, Rubio S, De Lucas JJ, Díaz DC, San Andrés MI. Pharmacokinetic behavior and pharmacokinetic/pharmacodynamic indices of marbofloxacin after intravenous, subcutaneous, and intramuscular administrations in buffalo calves (<10 days old). J Vet Pharmacol Ther 2011; 35:301-4. [PMID: 21812790 DOI: 10.1111/j.1365-2885.2011.01325.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Carlos Lüders
- Escuela de Medicina Veterinaria, Universidad Católica de Temuco, Casilla 15D, Temuco, Chile
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Haritova A, Urumova V, Lutckanov M, Petrov V, Lashev L. Pharmacokinetic-pharmacodynamic indices of enrofloxacin in Escherichia coli O78/H12 infected chickens. Food Chem Toxicol 2011; 49:1530-6. [PMID: 21458518 DOI: 10.1016/j.fct.2011.03.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 03/15/2011] [Accepted: 03/24/2011] [Indexed: 10/18/2022]
Abstract
Aim of the study was to evaluate the effect of quercetin and enrofloxacin with/without quercetin on elimination of pathogen Escherichia coli O78/H12 in infected chickens. Effect of quercetin on disposition of enrofloxacin was investigated and Pharmacokinetic-pharmacodynamic indices were calculated. Enrofloxacin was absorbed after oral administration in infected animals but with large inter-individual variations. Low concentrations of its main metabolite, ciprofloxacin, were found which could be explained with marked reduction of enrofloxacin transformation in infected animals. Quercetin significantly decreased bioavailability of enrofloxacin and its transformation to ciprofloxacin. Lower formation of metabolite was also found in the studied tissues as spleen, heart, lungs and in liver of group treated in combination with quercetin. Results in infected and quercetin (50 mg/kg) treated group shows lower percentage of re-isolates of the pathogen bacteria in comparison to infected and untreated animals, and close to the low dose (10 mg/kg) of enrofloxacin. High dose of enrofloxacin given in a short time in an infection model with high inoculum size, resulted in better eradication of bacteria although re-isolates could be found in spleen. Additional improvement of the outcome of fluoroquinolone therapy could be searched in early start of drug administration according to the terms of metaphylaxis.
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Affiliation(s)
- Aneliya Haritova
- Department of Pharmacology, Physiology and Chemistry, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria.
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Dheilly A, Bouder A, Le Devendec L, Hellard G, Kempf I. Clinical and microbial efficacy of antimicrobial treatments of experimental avian colibacillosis. Vet Microbiol 2010; 149:422-9. [PMID: 21185134 DOI: 10.1016/j.vetmic.2010.11.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 11/23/2010] [Accepted: 11/26/2010] [Indexed: 11/19/2022]
Abstract
The clinical and microbial efficacy of antimicrobial treatments of avian colibacillosis was studied, using an experimental model on chickens previously inoculated with multiresistant commensal Escherichia coli strains. One E. coli with pMG252 plasmid containing bla(FOX5) and qnrA1 genes and another E. coli with pMG298 plasmid containing bla(CTX-M15) and qnrB1 genes were first orally inoculated to chickens Both isolates were also resistant to chloramphenicol, sulphamethoxazole, trimethoprim, streptomycin, gentamicin, kanamycin, and tetracycline. The birds were then experimentally infected with an avian pathogenic E. coli (APEC), via the air sac. Treatments (oxytetracycline (OTC), trimethoprim-sulfadimethoxin (SXT), amoxicillin (AMX) or enrofloxacin (ENR) were then offered at the therapeutic doses. Symptoms, lesions in dead or sacrificed birds, and isolation and characterization of APEC from internal organs were studied. Results showed that OTC, SXT or ENR treatments could control the pathology. AMX worsened the disease, possibly due to endotoxin shock. All APEC re-isolated from internal organs showed the same antimicrobial susceptibility as the APEC inoculated strain, except for one APEC isolate from an infected OTC-treated bird, which acquired tetracycline resistance only, and one APEC isolate recovered from the air sacs of a chicken in the infected SXT-treated group, which acquired the pMG252 plasmid and became multi-resistant. Thus three antimicrobials could control the disease but the experimental model enabled, to our knowledge, the first observation of plasmid transfer from a bacterium of the intestinal tract to a pathogenic isolate from the respiratory tract.
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Affiliation(s)
- Alexandra Dheilly
- Anses, Laboratoire de Ploufragan, Zoopole Les Croix, F-22440 Ploufragan, France
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SIDHU PK, LANDONI MF, ALIABADI MHS, TOUTAIN PL, LEES P. Pharmacokinetic and pharmacodynamic modelling of marbofloxacin administered alone and in combination with tolfenamic acid in calves. J Vet Pharmacol Ther 2010; 34:376-87. [DOI: 10.1111/j.1365-2885.2010.01247.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hu CY, Chai XZ, Zhou HQ, Wang SF. Mutant prevention concentrations of fluoroquinolones against Helicobacter pylori. Shijie Huaren Xiaohua Zazhi 2010; 18:3347-3351. [DOI: 10.11569/wcjd.v18.i31.3347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the mutant prevention concentrations (MPC) of four fluoroquinolones against fluoroquinolone-susceptible clinical Helicobacter pylori (H.pylori) isolates.
METHODS: Sixteen clinical isolates of H.pylori were enriched in broth and adjusted to 1010 colony-forming units per milliliter. The minimal inhibitory concentration (MIC) and provisional MPC (MPCpr) of moxifloxacin, gatifloxacin, levofloxacin and ciprofloxacin were determined using the agar plate dilution method. The 50% MIC (MIC50), 90% MIC (MIC90), and 90% provisional MPC (MPCpr90) for fluoroquinolone-susceptible H.pylori isolates were then calculated.
RESULTS: When the breakpoints for fluoroquinolone resistance were defined as >1.0 mg/L, there were 2, 1, 4 and 2 H.pylori strains resistant to moxifloxacin, gatifloxacin, levofloxacin and ciprofloxacin, respectively. The MIC50 of moxifloxacin, gatifloxacin, levofloxacin and ciprofloxacin for fluoroquinolone-susceptible H.pylori isolates were 0.13, 0.13, 0.25 and 0.50, respectively, while the MIC90 were 0.50, 0.50, 1.00 and 0.50 mg/L, respectively. The MPCpr90 of moxifloxacin, gatifloxacin, levofloxacin and ciprofloxacin were 8.0, 2.0, 8.0 and 2.0 mg/L, and the ratios of MPCpr90 to MIC90 were 16.0, 4.0, 8.0 and 4.0, respectively.
CONCLUSION: The anti-H.pylori activity of gatifloxacin and moxifloxacin might be stronger than that of levofloxacin and ciprofloxacin, and the capacity of gatifloxacin and ciprofloxacin restricting the selection of resistant mutants appears to be stronger than that of moxifloxacin and levofloxacin in the treatment of H.pylori infection.
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Ferran AA, Toutain PL, Bousquet-Mélou A. Impact of early versus later fluoroquinolone treatment on the clinical; microbiological and resistance outcomes in a mouse-lung model of Pasteurella multocida infection. Vet Microbiol 2010; 148:292-7. [PMID: 20888712 DOI: 10.1016/j.vetmic.2010.09.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 08/31/2010] [Accepted: 09/02/2010] [Indexed: 10/19/2022]
Abstract
The early curative uses of antimicrobial drugs such as fluoroquinolones before the onset of symptoms in veterinary medicine may be regarded as irrational antibiotic consumption. However, it should be stressed that in early curative antimicrobial treatment as in metaphylaxis, the bacterial burden at the infection site is often very low, and so the rapid eradication of the bacterial population could result. We investigated the impact of early versus later curative administrations of 1 or 40 mg/kg of marbofloxacin on the survival of mice, the eradication of the targeted pathogen and the selection of resistant bacteria in a mouse lung infection with Pasteurella multocida. In this model, for a given marbofloxacin dose, the clinical and bacteriological outcomes were better, and the selection of resistance less frequent, for the early rather than for the late treatment. Moreover, the early administration of 1mg/kg led to better clinical and similar bacteriological (eradication and selection of resistance) outcomes than the late administration of 40 mg/kg marbofloxacin. Our results suggest that the optimal doses for the animals' cure could be lower when administered early during the time course of the infection than when administered after the disease outbreak. As the main argument against early treatments such as metaphylaxis is the possible enhancement of resistance at the gut level, further studies should assess if lower doses of antibiotic administered to all the animals of a herd could have less impact on the commensal digestive flora than higher doses only administered to animals showing clinical symptoms.
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Affiliation(s)
- Aude A Ferran
- UMR181 Physiopathologie et Toxicologie Expérimentales, INRA, ENVT, Ecole Nationale Vétérinaire de Toulouse, 23 chemin des Capelles, BP 87 614, 31076 Toulouse Cedex 3, France
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Emergence of resistant Klebsiella pneumoniae in the intestinal tract during successful treatment of Klebsiella pneumoniae lung infection in rats. Antimicrob Agents Chemother 2010; 54:2960-4. [PMID: 20457820 DOI: 10.1128/aac.01612-09] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Antibiotic treatment of lung infections may lead to the emergence of resistance in the gut flora. Appropriate dosing regimens could mitigate this adverse effect. In gnotobiotic rats harboring intestinal Escherichia coli and Enterococcus faecium populations, a lung infection by Klebsiella pneumoniae was instigated with two different sizes of inoculum to represent an early or a late initiation of antibiotic treatment. The rats were treated with marbofloxacin, an expanded-spectrum fluoroquinolone, by a single-shot administration or a fractionated regimen over 4 days. Intestinal bacterial populations were monitored during and after treatment. At the infection site, bacterial cure without any selection of resistance was observed. Whatever the dosage regimen, fluoroquinolone treatment had a transient negative impact on the E. coli gut population but not on that of E. faecium. The intestinal flora was colonized by the pathogenic lung bacteria, and there was the emergence of intestine-resistant K. pneumoniae, occurring more often in animals treated with a single marbofloxacin dose than with the fractionated dose. Bacterial cure without resistance selection at the infection site with fluoroquinolone treatment can be linked to colonization of the digestive tract by targeted pulmonary bacteria, followed by the emergence of resistance.
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