Pharmacodynamic target attainment of seven antimicrobials against Gram-negative bacteria collected from China in 2003 and 2004

• Published in: International journal of antimicrobial agents Vol. 30; no. 5; pp. 452 - 457
• Main Authors: Wang, Hui, Zhang, Bo, Ni, Yuxing, Kuti, Joseph L, Chen, Baiyi, Chen, Minjun, Nicolau, David P
• Format: Journal Article
• Language: English
• Published: London Elsevier B.V 01-11-2007; Amsterdam Elsevier; New York, NY
• Subjects: Acinetobacter baumannii; Anti-Bacterial Agents - pharmacokinetics; Antibiotic; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial resistance; Biological and medical sciences; China; Computer Simulation; Enterobacteriaceae; Enterobacteriaceae - drug effects; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - microbiology; Escherichia coli; Humans; Infectious Disease; Klebsiella pneumoniae; Medical sciences; Microbial Sensitivity Tests; Monte Carlo Method; Pharmacodynamics; Pharmacology. Drug treatments; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Pseudomonas Infections - drug therapy; Pseudomonas Infections - microbiology; Asia; China; Antibiotic; Pharmacodynamics; Bacterial resistance; Infection; Resistance; Target; Targeting; Bacteriosis; Antibacterial agent; Biological activity; Antimicrobial agent; Gram negative bacteria
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2007.06.005

Abstract Using minimum inhibitory concentration (MIC) data derived from a Chinese national surveillance study and pharmacokinetic data collected in Chinese individuals, a 5000-subject Monte Carlo simulation was conducted to determine the cumulative fraction of response (CFR) for cefoperazone/sulbactam, cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, imipenem and meropenem against Escherichia coli , Klebsiella pneumoniae , Acinetobacter baumannii and Pseudomonas aeruginosa collected during 2003 and 2004. The carbapenems had the highest CFRs against the Enterobacteriaceae (94.7–100%) and A. baumannii (66.0–86.3%). Ceftazidime, meropenem and cefoperazone/sulbactam obtained the greatest CFRs against P. aeruginosa (73.9–86.6% in Southern China and 64.8–82.1% in Northern China). All other cephalosporin and ciprofloxacin regimens achieved ≤50% CFR against all bacterial species. Meropenem 2 g every 8 h as a 3-h infusion displayed ca. 90% CFR against A. baumannii and P. aeruginosa . Pharmacodynamic analyses are useful for selecting optimal compounds and dosing regimens as initial empirical therapy against these organisms in China.