title: Pharmacokinetic and pharmacodynamic models of the antistaphylococcal effects of meropenem and cloxacillin in vitro and in experimental infection.
abstract: The efficacies of meropenem (MPM) and cloxacillin (CLC) against two Staphylococcus aureus strains were established in vitro. A pharmacodynamic model equation, based on the concept that the killing rate depends on concentration and time, was fitted to the numbers of CFU. The parameters of the equation are maximum killing rate, time point of maximum killing, and 50% effective concentration (EC50). The EC50s for the two strains were 0.047 and 0.040 mg/liter, respectively, for MPM and 0.105 and 0.121 mg/liter, respectively, for CLC. Calculated values of the parameters were used to predict the numbers of CFU at exponentially decreasing concentrations in vitro as well as in an experimental infection model. The prediction for in vitro conditions gave a satisfactory fit (R2, between 0.862 and 0.894). In vivo the numbers were predicted with the assumption that killing rate in vivo is proportional to that in vitro (R2, between 0.731 and 0.973). The proportionality factor ranged between 0.23 and 0.42; this variation was due mainly to covariation with growth rates in control animals, without other significant differences between antibiotics or strains.
authors.affiliation: Department of Infectious Diseases, University Hospital Leiden, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Mattie
authors.forename: L C
authors.initials: LC
authors.lastname: Zhang
authors.forename: E
authors.initials: E
authors.lastname: van Strijen
authors.forename: B R
authors.initials: BR
authors.lastname: Sekh
authors.forename: A E
authors.initials: AE
authors.lastname: Douwes-Idema
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D003023:Cloxacillin / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D005260:Female; D000077731:Meropenem; D051379:Mice; D008826:Microbial Sensitivity Tests; D011485:Protein Binding; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D013845:Thienamycins / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000077731:Meropenem; D003023:Cloxacillin