Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation
© 2018, Medical Association of Thailand. All rights reserved. Objective: To estimate the probability of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin achieving pharmacokinetic/pharmacodynamics [PK/PD] targets against Streptococcus pneumoniae in Thais. Materials and Methods:...
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th-mahidol.468882019-08-28T13:21:12Z Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation Sermwoot Jannual Preecha Montakantikul Jantana Houngsaitong Visanu Thamlikitkul Paveena Sonthisombat Naresuan University Mahidol University Faculty of Medicine, Siriraj Hospital, Mahidol University Medicine © 2018, Medical Association of Thailand. All rights reserved. Objective: To estimate the probability of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin achieving pharmacokinetic/pharmacodynamics [PK/PD] targets against Streptococcus pneumoniae in Thais. Materials and Methods: A Monte Carlo simulation of 10,000 S. pneumoniae infected patients was conducted. Steady-state serum drug concentration-time profiles were created to determine the probability of target attainments at each minimum inhibitory concentration [MIC]. The MICs of 100 S. pneumoniae isolates were used. The cumulative fraction of responses [CFRs] were calculated to provide a single estimate of the probability of achieving PK/PD targets for dosage regimens against S. pneumoniae populations. A CFR of more than 90% was required. Results: One third of S. pneumoniae isolates were susceptible to penicillin. The MICs90 of amoxicillin-based regimens, cefditoren, and azithromycin against S. pneumoniae were 2, 0.5, and 128 μg/ml, respectively. The probability of achieving PK/PD targets of all amoxicillin-based regimens and cefditoren 200 mg every eight hours were more than 90% for MIC90 values, while that of azithromycin 500 mg daily was 0%. All amoxicillin-based regimens, cefditoren 200 mg every eight hours, and cefditoren 400 mg every 12 hours achieved the CFR target, while azithromycin did not. Conclusion: Based on the simulations, amoxicillin-based regimens or high-dose cefditoren provided a greater likelihood of achieving optimal PK/PD targets in adults with S. pneumoniae-related respiratory tract infections [RTIs]. 2019-08-28T06:21:12Z 2019-08-28T06:21:12Z 2018-03-01 Article Journal of the Medical Association of Thailand. Vol.101, No.3 (2018), 305-312 01252208 2-s2.0-85046409393 https://repository.li.mahidol.ac.th/handle/123456789/46888 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046409393&origin=inward |
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Medicine Sermwoot Jannual Preecha Montakantikul Jantana Houngsaitong Visanu Thamlikitkul Paveena Sonthisombat Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation |
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© 2018, Medical Association of Thailand. All rights reserved. Objective: To estimate the probability of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin achieving pharmacokinetic/pharmacodynamics [PK/PD] targets against Streptococcus pneumoniae in Thais. Materials and Methods: A Monte Carlo simulation of 10,000 S. pneumoniae infected patients was conducted. Steady-state serum drug concentration-time profiles were created to determine the probability of target attainments at each minimum inhibitory concentration [MIC]. The MICs of 100 S. pneumoniae isolates were used. The cumulative fraction of responses [CFRs] were calculated to provide a single estimate of the probability of achieving PK/PD targets for dosage regimens against S. pneumoniae populations. A CFR of more than 90% was required. Results: One third of S. pneumoniae isolates were susceptible to penicillin. The MICs90 of amoxicillin-based regimens, cefditoren, and azithromycin against S. pneumoniae were 2, 0.5, and 128 μg/ml, respectively. The probability of achieving PK/PD targets of all amoxicillin-based regimens and cefditoren 200 mg every eight hours were more than 90% for MIC90 values, while that of azithromycin 500 mg daily was 0%. All amoxicillin-based regimens, cefditoren 200 mg every eight hours, and cefditoren 400 mg every 12 hours achieved the CFR target, while azithromycin did not. Conclusion: Based on the simulations, amoxicillin-based regimens or high-dose cefditoren provided a greater likelihood of achieving optimal PK/PD targets in adults with S. pneumoniae-related respiratory tract infections [RTIs]. |
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Naresuan University |
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Naresuan University Sermwoot Jannual Preecha Montakantikul Jantana Houngsaitong Visanu Thamlikitkul Paveena Sonthisombat |
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Article |
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Sermwoot Jannual Preecha Montakantikul Jantana Houngsaitong Visanu Thamlikitkul Paveena Sonthisombat |
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title |
Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation |
title_short |
Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation |
title_full |
Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation |
title_fullStr |
Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation |
title_full_unstemmed |
Pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: A monte carlo simulation |
title_sort |
pharmacodynamic evaluation of oral amoxicillin, amoxicillin/clavulanate, cefditoren, and azithromycin against streptococcus pneumoniae-caused respiratory tract infections: a monte carlo simulation |
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2019 |
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https://repository.li.mahidol.ac.th/handle/123456789/46888 |
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1763491488074825728 |