Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.
Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China, Shanghai, China.
Antimicrob Agents Chemother. 2022 Jun 21;66(6):e0243021. doi: 10.1128/aac.02430-21. Epub 2022 May 16.
This study aimed to build a population pharmacokinetic (PopPK) model for contezolid tablet (MRX-I) in healthy subjects and adults with complicated skin and soft-tissue infections (cSSTIs) to further evaluate the efficacy and safety of contezolid and recommend the optimal dosing regimen based on pharmacokinetic/pharmacodynamic (PK/PD) analysis. PopPK analysis was performed using a nonlinear mixed-effects model (NONMEM) to examine the effects of age, body weight, sex, liver and renal functions, albumin, food, dosage strength, and subject type on the PK parameters of contezolid. PK/PD analysis was combined with the MIC of contezolid, clinical/microbiological efficacy, and nonclinical study data. Adverse events (AEs) and study drug-related AEs reported were summarized to examine the relationship between contezolid exposure level and safety measures. A two-compartment model was built. An exponential model was used to describe the interindividual variation. A proportional model was used to describe the intraindividual variation of PK parameters. Good clinical and microbiological efficacy are expected for the infections caused by S. aureus when contezolid is administered at 600 mg or 800 mg every 12 h (q12h). The area under the concentration-time curve from 0 to 24 h at steady state and maximum concentration of drug in serum at steady state of contezolid did not show significant association with the incidence of any AE. The dosing regimen of contezolid at 800 mg q12h administered postprandially for 7 to 14 days is expected to achieve satisfactory clinical and microbiological efficacy in cSSTIs, which is slightly better than that of 600 mg contezolid. This administration has been added to the prescribing information of contezolid tablets.
本研究旨在建立康替唑片剂(MRX-I)在健康受试者和复杂性皮肤软组织感染(cSSTIs)成人中的群体药代动力学(PopPK)模型,以进一步评估康替唑的疗效和安全性,并根据药代动力学/药效学(PK/PD)分析推荐最佳给药方案。采用非线性混合效应模型(NONMEM)进行PopPK 分析,以考察年龄、体重、性别、肝肾功能、白蛋白、饮食、剂量强度和受试者类型对康替唑 PK 参数的影响。将 PK/PD 分析与康替唑的 MIC、临床/微生物学疗效以及非临床研究数据相结合。总结不良事件(AE)和与研究药物相关的 AE 报告,以考察康替唑暴露水平与安全性措施之间的关系。建立了两室模型。采用指数模型描述个体间变异。采用比例模型描述 PK 参数的个体内变异。当康替唑以 600mg 或 800mg 每 12 小时(q12h)给药时,预计对金黄色葡萄球菌引起的感染具有良好的临床和微生物学疗效。稳态时 0 至 24 小时的浓度-时间曲线下面积和血清中药物的稳态最大浓度与任何 AE 的发生率没有显著相关性。康替唑 800mg q12h 餐后给药 7 至 14 天的给药方案有望在 cSSTIs 中实现满意的临床和微生物学疗效,略优于 600mg 康替唑。这一给药方案已被添加到康替唑片剂的说明书中。