PMID- 27290828
OWN - NLM
STAT- MEDLINE
DCOM- 20160721
LR  - 20161116
IS  - 0368-2781 (Print)
IS  - 0368-2781 (Linking)
VI  - 69
IP  - 1
DP  - 2016 Feb
TI  - [Susceptibility of clinically-isolated bacteria strains to respiratory quinolones 
      and evaluation of antimicrobial agent efficacy by Monte Carlo simulation].
PG  - 27-40
AB  - Respiratory quinolones (RQs) are broad-spectrum antimicrobial agents used for the 
      treatment of a wide variety of community-acquired and nosocomial infections. 
      However, bacterial resistance to quinolones has been on the increase. In this 
      study, we investigated the predicted efficacy of RQs for various strains of 9 
      bacterial species clinically isolated at our university hospital using the Monte 
      Carlo simulation (MCS) method based on pharmacokinetics/pharmacodynamics 
      modeling. In addition, the influence of the patients' renal function on the 
      efficacy of RQs was evaluated. We surveyed antimicrobial susceptibility testing 
      of 9 bacterial species (n = number of strains) [Streptococcus pneumoniae (n = 
      15), Streptococcus pyogenes (n = 14), Streptococcus agalactiae (n = 19), 
      methicillin-susceptible Staphylococcus aureus (MSSA) (n = 24), Escherichia coli 
      (n = 35), Haemophilus influenzae (n = 17), Klebsiella pneumoniae (n = 14), 
      Pseudomonas aeruginosa (n = 31), and Moraxella catarrhalis (n = 11)] to 4 RQs 
      [garenoxacin (GRNX), levofloxacin (LVFX), sitafloxacin (STFX), and moxifloxacin 
      (MFLX)]. We found that compared with the other RQs, Gram-positive cocci was most 
      resistant to LVFX, and that the minimum inhibitory concentration (MIC(9)(0)) values 
      for S. pneumoniae, S. pyogenes, S. agalactiae, and MSSA were high (2, 16, > 16, 
      and 8 microg/mL, respectively). In regard to Gram-negative rods, the susceptibility 
      of E. coli to RQs was found to be decreased, with the MIC(9)(0) values of GRNX, LVFX, 
      STFX, and MFLX being > 16, 16, 1, and 16 microg/mL, respectively. MCS revealed that 
      the target attainment rate of the area under the unbound concentration-time curve 
      divided by the MIC(9)(0) (f . AUC/MIC ratio), against S. pneumoniae was 86.9-100%, 
      but against E. coli was low (52.1-66.2%). The f . AUC/MIC target attainment rate 
      of LVFX against S. pneumoniae, S. pyogenes, and S. agalactiae tended to decrease 
      due to increased creatinine clearance, and that of LVFX and STFX against MSSA 
      also tended to decrease. The findings of this study suggest that the drug 
      susceptibility distribution of each RQ varies, even within the same bacterial 
      species, and that the expected efficacy also varies between the drugs. Moreover, 
      the influence of the patient's renal function on the efficacy differed among the 
      3 renal excretory drugs (GRNX, LVFX, and STFX), thus suggesting that the efficacy 
      also differs. In conclusion, the findings of this study show that for the 
      administration of RQs, it is desirable to select agents in consideration of 
      surveyed sensitivity within the population and the pharmacokinetic 
      characteristics.
FAU - Kosaka, Tadashi
AU  - Kosaka T
FAU - Yamada, Yukiji
AU  - Yamada Y
FAU - Kimura, Takeshi
AU  - Kimura T
FAU - Kodama, Mai
AU  - Kodama M
FAU - Fujitomo, Yumiko
AU  - Fujitomo Y
FAU - Masaki, Nakanishi
AU  - Masaki N
FAU - Toshiaki, Komori
AU  - Toshiaki K
FAU - Keisuke, Shikata
AU  - Keisuke S
FAU - Fujita, Naohisa
AU  - Fujita N
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Jpn J Antibiot
JT  - The Japanese journal of antibiotics
JID - 0154402
RN  - 0 (Anti-Infective Agents)
RN  - 0 (Quinolones)
SB  - IM
MH  - Anti-Infective Agents/*pharmacology
MH  - Bacteria/*drug effects
MH  - Humans
MH  - Microbial Sensitivity Tests
MH  - *Monte Carlo Method
MH  - Quinolones/*pharmacology
EDAT- 2016/06/14 06:00
MHDA- 2016/07/22 06:00
CRDT- 2016/06/14 06:00
PHST- 2016/06/14 06:00 [entrez]
PHST- 2016/06/14 06:00 [pubmed]
PHST- 2016/07/22 06:00 [medline]
PST - ppublish
SO  - Jpn J Antibiot. 2016 Feb;69(1):27-40.