Pharmacokinetic-pharmacodynamic profiling of four antimicrobials against gram-negative bacteria collected from Shenyang, China.
BACKGROUND
To examine common antimicrobial regimens used in eradicating certain nosocomial gram-negative pathogens and determine which ones are likely to be the most suitable as empirical choices in Shenyang, China.


METHODS
A 5000-subject Monte Carlo simulation was conducted to determine the cumulative fraction of response (CFR) for meropenem, imipenem, cefepime, piperacillin/tazobactam and levofloxacin against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii and Pseudomonas aeruginosa collected in 2006 and 2007 from Shenyang.


RESULTS
Meropenem and imipenem had the highest CFRs against the Enterobacteriaceae (97%-100%), followed by cefepime. No antibiotic simulated regimen achieved optimal CFR against P. aeruginosa and A. baumannii. Piperacillin/tazobactam dosed at 4.5 g q8h achieved the lowest CFR against all bacteria.


CONCLUSIONS
This study suggests that the carbapenems provide the greatest likelihood of clinical success for the Enterobacteriaceae, and combination therapy might be needed when choosing empirical therapy, especially when A. baumannii or P. aeruginosa are suspected.
Chu
Yun Zhuo
YZ
Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, 110001, China.
Tian
Su Fei
SF
Chen
Bai Yi
BY
Nian
Hua
H
Shang
Hong
H
Sun
Guo Quan
GQ
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology*; D002681:China; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D047090:beta-Lactams / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D047090:beta-Lactams