Andes D R, Craig W A
William S. Middleton Memorial Veterans Affairs Hospital, Madison, Wisconsin, USA.
Clin Infect Dis. 1998 Jul;27(1):47-50. doi: 10.1086/514624.
We calculated the magnitude of various serum pharmacodynamic parameters for fluoroquinolones in models of experimental endocarditis (EE) described in the literature. Nineteen publications contained data that allowed calculation of these parameters. Data were available for eight fluoroquinolones against methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, methicillin-resistant Staphylococcus epidermidis, viridans streptococci, Enterobacter aerogenes, and Pseudomonas aeruginosa in rabbit or rat models. Enterococci were excluded because of poor bactericidal activity. A 24-hour area under the concentration curve (AUC)/minimal inhibitory concentration (MIC) ratio > or = 100, a peak level/MIC ratio > 8, and continuous levels above the time were associated with a significantly lower number of cfu per vegetation after 3-6 days of therapy. The 24-hour AUC/MIC exhibited the best linear correlation with cfu per vegetation after 3-6 days of therapy (r2 = 45%). The pharmacodynamic parameters predictive of efficacy for fluoroquinolones in the treatment of experimental endocarditis are similar to those for other infectious models.
我们计算了文献中描述的实验性心内膜炎（EE）模型中氟喹诺酮类药物各种血清药效学参数的大小。19篇出版物包含可用于计算这些参数的数据。在兔或大鼠模型中，有针对对甲氧西林敏感的金黄色葡萄球菌、耐甲氧西林金黄色葡萄球菌、耐甲氧西林表皮葡萄球菌、草绿色链球菌、产气肠杆菌和铜绿假单胞菌的8种氟喹诺酮类药物的数据。由于杀菌活性差，肠球菌被排除在外。治疗3 - 6天后，24小时浓度曲线下面积（AUC）/最低抑菌浓度（MIC）比值≥100、峰浓度/MIC比值>8以及持续高于该时间的血药浓度与每赘生物的菌落形成单位（cfu）数量显著减少相关。治疗3 - 6天后，24小时AUC/MIC与每赘生物的cfu呈现出最佳的线性相关性（r2 = 45%）。氟喹诺酮类药物治疗实验性心内膜炎的药效学预测疗效参数与其他感染模型相似。
