Dorey L, Pelligand L, Cheng Z, Lees P
Department of Comparative Biological Sciences, The Royal Veterinary College, Hatfield, UK.
J Vet Pharmacol Ther. 2017 Oct;40(5):505-516. doi: 10.1111/jvp.12385. Epub 2017 Jan 16.
Pharmacokinetic-pharmacodynamic (PK/PD) integration and modelling were used to predict dosage schedules of oxytetracycline for two pig pneumonia pathogens, Actinobacillus pleuropneumoniae and Pasteurella multocida. Minimum inhibitory concentration (MIC) and mutant prevention concentration (MPC) were determined in broth and porcine serum. PK/PD integration established ratios of average concentration over 48 h (C )/MIC of 5.87 and 0.27 μg/mL (P. multocida) and 0.70 and 0.85 μg/mL (A. pleuropneumoniae) for broth and serum MICs, respectively. PK/PD modelling of in vitro time-kill curves established broth and serum breakpoint values for area under curve (AUC )/MIC for three levels of inhibition of growth, bacteriostasis and 3 and 4 log reductions in bacterial count. Doses were then predicted for each pathogen, based on Monte Carlo simulations, for: (i) bacteriostatic and bactericidal levels of kill; (ii) 50% and 90% target attainment rates (TAR); and (iii) single dosing and daily dosing at steady-state. For 90% TAR, predicted daily doses at steady-state for bactericidal actions were 1123 mg/kg (P. multocida) and 43 mg/kg (A. pleuropneumoniae) based on serum MICs. Lower TARs were predicted from broth MIC data; corresponding dose estimates were 95 mg/kg (P. multocida) and 34 mg/kg (A. pleuropneumoniae).
采用药代动力学-药效学(PK/PD)整合与建模方法,预测了土霉素对两种猪肺炎病原体——胸膜肺炎放线杆菌和多杀性巴氏杆菌的给药方案。在肉汤和猪血清中测定了最低抑菌浓度(MIC)和突变预防浓度(MPC)。PK/PD整合分别确定了肉汤和血清MIC情况下,48小时平均浓度(C)与MIC的比值,多杀性巴氏杆菌在肉汤和血清中的比值分别为5.87和0.27μg/mL,胸膜肺炎放线杆菌在肉汤和血清中的比值分别为0.70和0.85μg/mL。体外时间杀菌曲线的PK/PD建模确定了曲线下面积(AUC)与MIC的肉汤和血清断点值,用于三种生长抑制水平,即抑菌以及细菌计数减少3和4个对数。然后,基于蒙特卡洛模拟,针对每种病原体预测了以下剂量:(i)抑菌和杀菌水平的杀灭效果;(ii)50%和90%的目标达成率(TAR);(iii)单剂量给药和稳态下的每日给药。对于90%的TAR,基于血清MIC,预测稳态下杀菌作用的每日剂量多杀性巴氏杆菌为1123mg/kg,胸膜肺炎放线杆菌为43mg/kg。根据肉汤MIC数据预测的TAR较低;相应的剂量估计多杀性巴氏杆菌为95mg/kg,胸膜肺炎放线杆菌为34mg/kg。