Vol.52 No.9 September 2004
Study of clinical significance of PK/PD (pharmacokinetic/pharmacodynamic) parameters after administering arbekacin to patients with pulmonary methicillin-resistant Staphylococcus aureus infection
1)Department of Clinical Pathology, Tenri Hospital, 200 Mishima, Tenri, Nara, Japan
2)Department of Pharmacy, Tenri Hospital
Abstract
Pharmacokinetic/pharmacodynamic (PK/PD) parameters are useful predictors of clinical efficacy and bacterial eradication. Aminoglycosides have concentration-dependent antibacterial activity and the Cmax/MIC ratio of aminoglycosides correlates with clinical efficacy.
We retrospectively studied 44 cases of pulmonary MRSA infection treated with arbekacin (ABK) to determine the significance of PK/PD parameters. The ABK serum concentration was determined by FPIA, PK parameters were calculated, and 1-compartment model simulation was done. Cmax/MIC of 8 or more was statistically shown to be predictive for clinical efficacy [P< 0.01, odds ratio (OR)=27.1 (95% confidential interval (CI)=3.1-237)] and the correlation of Cmax/MIC with bacterial eradication [P< 0.01, OR=1.68 (95%CI=1.2-2.3)] was also statistically predictive. These results suggest that the Cmax/MIC ratio correlates with clinical efficacy and bacterial eradication, and thus PK/PD parameters integrating ABK MIC as a PD parameter covariate for the PK parameter Cmax should be estimated to optimize MRSA treatment.
Key word
MRSA, arbekacin, PK/PD, Cmax, AUC, MIC
Received
May 24, 2004
Accepted
August 17, 2004
Jpn. J. Chemother. 52 (9): 469-473, 2004
