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Integrative model-based comparison of target site-specific antimicrobial effects: A case study with ceftaroline and lefamulin.
van Os, Wisse; Pham, Anh Duc; Eberl, Sabine; Minichmayr, Iris K; van Hasselt, J G Coen; Zeitlinger, Markus.
Afiliación
  • van Os W; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
  • Pham AD; Division of Systems Pharmacology & Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, Leiden, Netherlands.
  • Eberl S; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
  • Minichmayr IK; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
  • van Hasselt JGC; Division of Systems Pharmacology & Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, Leiden, Netherlands.
  • Zeitlinger M; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. Electronic address: markus.zeitlinger@meduniwien.ac.at.
Int J Antimicrob Agents ; 63(5): 107148, 2024 May.
Article en En | MEDLINE | ID: mdl-38508535
ABSTRACT

OBJECTIVE:

Predictions of antimicrobial effects typically rely on plasma-based pharmacokinetic-pharmacodynamic (PK-PD) targets, ignoring target-site concentrations and potential differences in tissue penetration between antibiotics. In this study, we applied PK-PD modelling to compare target site-specific effects of antibiotics by integrating clinical microdialysis data, in vitro time-kill curves, and antimicrobial susceptibility distributions. As a case study, we compared the effect of lefamulin and ceftaroline against methicillin-resistant Staphylococcus aureus (MRSA) at soft-tissue concentrations.

METHODS:

A population PK model describing lefamulin concentrations in plasma, subcutaneous adipose and muscle tissue was developed. For ceftaroline, a similar previously reported PK model was adopted. In vitro time-kill experiments were performed with six MRSA isolates and a PD model was developed to describe bacterial growth and antimicrobial effects. The clinical PK and in vitro PD models were linked to compare antimicrobial effects of ceftaroline and lefamulin at the different target sites.

RESULTS:

Considering minimum inhibitory concentration (MIC) distributions and standard dosages, ceftaroline showed superior anti-MRSA effects compared to lefamulin both at plasma and soft-tissue concentrations. Looking at the individual antibiotics, lefamulin effects were highest at soft-tissue concentrations, while ceftaroline effects were highest at plasma concentrations, emphasising the importance of considering target-site PK-PD in antibiotic treatment optimisation.

CONCLUSION:

Given standard dosing regimens, ceftaroline appeared more effective than lefamulin against MRSA at soft-tissue concentrations. The PK-PD model-based approach applied in this study could be used to compare or explore the potential of antibiotics for specific indications or in populations with unique target-site PK.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos Policíclicos / Pruebas de Sensibilidad Microbiana / Cefalosporinas / Diterpenos / Staphylococcus aureus Resistente a Meticilina / Ceftarolina / Antibacterianos Límite: Humans Idioma: En Revista: Int J Antimicrob Agents Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos Policíclicos / Pruebas de Sensibilidad Microbiana / Cefalosporinas / Diterpenos / Staphylococcus aureus Resistente a Meticilina / Ceftarolina / Antibacterianos Límite: Humans Idioma: En Revista: Int J Antimicrob Agents Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Países Bajos