Miyazaki Shuichi, Okazaki Kenichi, Tsuji Masakatsu, Yamaguchi Keizo
Department of Microbiology, Toho University School of Medicine, Omori-nishi, 5-21-16, Ota-ku, Tokyo 143-8540, Japan.
Antimicrob Agents Chemother. 2004 Feb;48(2):378-83. doi: 10.1128/AAC.48.2.378-383.2004.
S-3578 is a novel beta-lactam with enhanced activity against drug-resistant gram-positive cocci such as methicillin-resistant Staphylococcus aureus (MRSA). We used murine penicillin-resistant Streptococcus pneumoniae lung infection and neutropenic murine systemic MRSA infection models to determine the pharmacokinetic (PK)-pharmacodynamic (PD) parameter that best correlated with efficacy. Pharmacokinetic studies revealed that the maximum concentration in serum/dose values for S-3578 and cefepime in plasma in the lung infection model were 1.21 to 1.54 and 0.97 to 1.29, respectively; those for S-3578 in plasma in the systemic infection model were 0.78 to 1.02. The area under the concentration-time curve (AUC)/dose values for S-3578 and cefepime in plasma in the lung infection model were 0.98 to 1.13 and 0.77 to 1.04, respectively, and those for S-3578 in plasma in the systemic infection model were 1.03 to 1.11. The half-lives of S-3578 and cefepime in plasma in the lung infection model were 0.29 to 0.38 and 0.29 to 0.34, respectively, and those of S-3578 in plasma in the systemic infection model were 0.40 to 0.61. The time above the MIC was the PK-PD parameter that best correlated with efficacy in the murine lung infection model (R(2) = 84 and 92% for S-3578 and cefepime in plasma, respectively). There was a twofold increase in the dose of S-3578 in the systemic infection model compared to that in the pneumonia model, yet the AUCs were the same. This may be due to the different MICs for the two pathogens.
S-3578是一种新型β-内酰胺类药物,对耐甲氧西林金黄色葡萄球菌(MRSA)等耐药革兰氏阳性球菌具有增强的活性。我们使用耐青霉素的小鼠肺炎链球菌肺部感染模型和中性粒细胞减少的小鼠全身性MRSA感染模型,来确定与疗效最相关的药代动力学(PK)-药效学(PD)参数。药代动力学研究表明,在肺部感染模型中,S-3578和头孢吡肟在血浆中的血清/剂量值的最大浓度分别为1.21至1.54和0.97至1.29;在全身性感染模型中,S-3578在血浆中的血清/剂量值的最大浓度为0.78至1.02。在肺部感染模型中,S-3578和头孢吡肟在血浆中的浓度-时间曲线下面积(AUC)/剂量值分别为0.98至1.13和0.77至1.04,在全身性感染模型中,S-3578在血浆中的AUC/剂量值为1.03至1.11。在肺部感染模型中,S-3578和头孢吡肟在血浆中的半衰期分别为0.29至0.38和0.29至0.34,在全身性感染模型中,S-3578在血浆中的半衰期为0.40至0.61。高于最低抑菌浓度(MIC)的时间是与小鼠肺部感染模型中的疗效最相关的PK-PD参数(S-3578和头孢吡肟在血浆中的R²分别为84%和92%)。与肺炎模型相比,全身性感染模型中S-3578的剂量增加了两倍,但AUC相同。这可能是由于两种病原体的MIC不同所致。