Winter Esther A, Pelligand Ludovic, Toutain Pierre-Louis, Lees Peter, Milanova Aneliya, Gehring Ronette
Veterinary Pharmacotherapy and Pharmacy, Department of Population Health Sciences, Utrecht University, Utrecht, Netherlands.
Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, United Kingdom.
Front Microbiol. 2024 Dec 4;15:1498219. doi: 10.3389/fmicb.2024.1498219. eCollection 2024.
A harmonized clinical breakpoint for interpreting antimicrobial susceptibility testing of oxytetracycline in cattle is currently lacking in Europe. This study aimed to establish a pharmacokinetic/pharmacodynamic (PK/PD) cutoff to propose clinical breakpoints, facilitating reliable interpretation of antimicrobial susceptibility results in cattle.
A meta-analysis of oxytetracycline pharmacokinetic data from 69 cattle was conducted, including 1,730 plasma concentration samples from animals administered 20 mg/kg intramuscularly and/or 20 or 40 mg/kg intravenously. A three-compartment model with two absorption phases was selected, incorporating age as a covariate for clearances and distribution volumes. The PK/PD cutoff was defined as the maximum MIC for which the AUC/MIC index achieves the pharmacodynamic target in 90% of cattle given the standard dosing regimen. The pharmacodynamic index (PDI) target selected was established to 24 h, i.e., the average free plasma concentration of oxytetracycline over the 24-h dosing interval, under steady-state conditions, is equal to the selected MIC.
Simulations indicated a PK/PD cutoff of 2 mg/L in adult cattle and 1 mg/L in calves for intramuscularly administered long-acting products at 20 mg/kg with a 48-hour efficacy duration. The difference is attributed to higher clearance rates in calves.
The established PK/PD cutoffs, when used alongside the wild-type bacterial epidemiological cutoff, can aid in setting clinical breakpoints for oxytetracycline, supporting effective antimicrobial therapy in cattle and accounting for age-related pharmacokinetic differences.
目前欧洲缺乏用于解释牛中土霉素抗菌药敏试验结果的统一临床断点。本研究旨在确定药代动力学/药效学(PK/PD)临界值以提出临床断点,从而便于对牛的抗菌药敏结果进行可靠解读。
对69头牛的土霉素药代动力学数据进行了荟萃分析,包括来自肌肉注射20 mg/kg和/或静脉注射20或40 mg/kg动物的1730份血浆浓度样本。选择了具有两个吸收相的三室模型,并将年龄作为清除率和分布容积的协变量纳入其中。PK/PD临界值定义为在给予标准给药方案的情况下,90%的牛中AUC/MIC指数达到药效学目标时的最大MIC。所选择的药效学指数(PDI)目标设定为24小时,即在稳态条件下,土霉素在24小时给药间隔内的平均游离血浆浓度等于所选的MIC。
模拟表明,对于肌肉注射20 mg/kg、药效持续时间为48小时的长效产品,成年牛的PK/PD临界值为2 mg/L,犊牛为1 mg/L。这种差异归因于犊牛较高的清除率。
既定的PK/PD临界值与野生型细菌流行病学临界值一起使用时,有助于设定土霉素的临床断点,支持牛的有效抗菌治疗,并考虑与年龄相关的药代动力学差异。