Pharmacodynamic target attainment of seven antimicrobials against Gram-negative bacteria collected from China in 2003 and 2004.
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 < or =50% CFR against all bacterial species. Meropenem 2g every 8h 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.
Wang
Hui
H
Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhang
Bo
B
Ni
Yuxing
Y
Kuti
Joseph L
JL
Chen
Baiyi
B
Chen
Minjun
M
Nicolau
David P
DP
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D002681:China; D003198:Computer Simulation; D004755:Enterobacteriaceae / Q000187:drug effects*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D009010:Monte Carlo Method; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*
D000900:Anti-Bacterial Agents