Evaluation of cephalosporins/cephamycins with antianaerobic activity by integrating microbiologic and pharmacokinetic properties.

摘要: When evaluating antimicrobial agents, in vitro microbiologic activity and pharmacokinetics are important factors, but these data usually not assessed simultaneously. The purpose of the study was to compare cefoxitin, cefotetan, ceftizoxime, cefotaxime (CT), desacetylcefotaxime (DACT), CT/DACT (1:1 ratio) by integrating their against clinical isolates Bacteroides fragilis with pharmacokinetic properties. Minimal inhibitory concentrations (MIC) were determined agar dilution method. Steady-state serum concentration--time profiles simulated for 2-gm doses a 70-kg patient using ADAPT software from published studies. Serum protein binding (%) each agent also obtained studies used calculate unbound profiles. As estimates pharmacodynamic activity, time below MIC (T less than MIC) percentage dosing interval (% INT calculated individual total concentrations. Data analysis included MIC50, MIC90, range, breakpoint susceptibility, variance T % (Scheffe post-hoc test, P 0.05). MIC90 cefotetan at least twofold lower other agents. However, (pharmacologically active) concentrations, ceftizoxime (at eight-hour interval) significantly smaller antibiotic regimens. Integration may provide additional information assist evaluation antimicrobials. For B our institution, profile is superior antianaerobic cephalosporins/cephamycins tested.