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1.
Biomed Chromatogr ; 38(11): e5964, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39252549

RESUMO

A liquid chromatography electrospray ionization tandem mass spectrometry method with amoxicillin-d4 as the stable isotope-labeled internal standard for simultaneous quick detection of amoxicillin and clavulanic acid in human plasma was developed and validated. Chromatographic separations were performed on a Hedera ODS-2 column (2.1 × 150 mm, 5 µm). The mobile phases for gradient elution were aqueous solution containing 0.2% acetic acid (AA) (mobile phase A) together with organic phase solution (acetonitrile and methanol mixed solution, mobile phase B). Mass spectrometry was performed using negative electrospray ionization in multiple reaction monitoring mode. The target fragment ion pairs of amoxicillin, clavulanic acid and amoxicillin-d4 were m/z 364.1 → 223.1, 198.1 → 135.9 and 368.1 → 227.1, respectively. The linear ranges of this method were 40-5,000 ng/ml for amoxicillin and 30-2,500 ng/ml for clavulanic acid, with coefficient of determination > 0.9900. This method validation included selectivity, standard curve, lower limit of quantitation, accuracy, precision, recovery, matrix effect (hemolytic matrix and hyperlipidemic matrix), carryover, stability, dilution reliability and incurred sample reanalysis study. A successful application of this method was realized in a pharmacokinetic study after administration of amoxicillin-clavulanic acid potassium granules.


Assuntos
Amoxicilina , Ácido Clavulânico , Limite de Detecção , Espectrometria de Massas por Ionização por Electrospray , Espectrometria de Massas em Tandem , Humanos , Espectrometria de Massas em Tandem/métodos , Espectrometria de Massas por Ionização por Electrospray/métodos , Reprodutibilidade dos Testes , Amoxicilina/sangue , Amoxicilina/farmacocinética , Amoxicilina/química , Cromatografia Líquida/métodos , Ácido Clavulânico/sangue , Ácido Clavulânico/farmacocinética , Modelos Lineares , Masculino , Sensibilidade e Especificidade , Estabilidade de Medicamentos
2.
Talanta ; 278: 126511, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-38986307

RESUMO

The application of advances in personalized medicine requires the support of in vitro diagnostic techniques aimed at the accurate, fast, sensitive, and precise determination of selected biomarkers. Herein, a novel optical centrifugal microfluidic device is developed for clinical analysis and point-of-care diagnostics. Based on compact disc technology, the integrated biophotonic system enables multiple immunoassays in miniaturized mode. The disposable microfluidic discs are made in cyclic olefin copolymer (COP), containing arrays of immobilized probes. In the developed approach, up to six patient samples can each be tested simultaneously. A portable instrument (<2 kg) controls the assay and the high-sensitive reproducible optical detection in transmission mode. Also, the instrument incorporates specific functionalities for personalized telemedicine. The device (analytical method, disc platform, reader, and software) has been validated to diagnose IgE-mediated drug allergies, such as amoxicillin and penicillin G. The total and specific IgE to ß-lactam antibiotics were determined in human serum from patients (25 µL). The excellent analytical performances (detection limit 0.24 ng/mL, standard deviation 7-20 %) demonstrated that the developed system could have the potential for a broader impact beyond the allergy field, as it applies to other IVD tests.


Assuntos
Biomarcadores , Imunoglobulina E , Humanos , Biomarcadores/sangue , Imunoglobulina E/sangue , Imunoensaio/métodos , Dispositivos Lab-On-A-Chip , Limite de Detecção , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/sangue , Técnicas Analíticas Microfluídicas/instrumentação , Amoxicilina/sangue
3.
Vet Res Commun ; 48(4): 2135-2144, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38630426

RESUMO

Feed and water components may interact with drugs and affect their dissolution and bioavailability. The impact of the vehicle of administration (feed and water) and the prandial condition of weaner piglets on amoxicillin´s oral bioavailability was evaluated. First, amoxicillin's in vitro dissolution and stability in purified, soft, and hard water, as well as release kinetics from feed in simulated gastric and intestinal media were assessed. Then, pharmacokinetic parameters and bioavailability were determined in fasted and fed pigs using soft water, hard water, or feed as vehicles of administration following a balanced incomplete block design. Amoxicillin showed similar dissolution profiles in soft and hard water, distinct from the dissolution profile obtained with purified water. Complete dissolution was only achieved in purified water, and merely reached 50% in soft or hard water. Once dissolved, antibiotic concentrations decreased by around 20% after 24 h in all solutions. Korsmeyer-Peppas model best described amoxicillin release from feed in simulated gastric and intestinal media. Feed considerably reduced antibiotic dissolution in both simulated media. In vivo, amoxicillin exhibited significantly higher bioavailability when delivered via water to fasted than to fed animals, while in-feed administration yielded the lowest values. All treatments showed a similar rate of drug absorption. In conclusion, we demonstrated that water and feed components, as well as feed present in gastrointestinal tract of piglets decrease amoxicillin´s oral bioavailability. Therefore, the use of oral amoxicillin as a broad-spectrum antibiotic to treat systemic infections in pigs should be thoroughly revised.


Assuntos
Amoxicilina , Ração Animal , Antibacterianos , Disponibilidade Biológica , Animais , Amoxicilina/farmacocinética , Amoxicilina/administração & dosagem , Amoxicilina/sangue , Ração Animal/análise , Antibacterianos/farmacocinética , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Administração Oral , Suínos , Água/química , Masculino , Feminino
4.
Arch Dis Child ; 105(12): 1208-1214, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32404437

RESUMO

BACKGROUND: WHO recommends simplified antibiotics for young infants with sepsis in countries where hospitalisation is not feasible. Amoxicillin provides safe, Gram-positive coverage. This study was done to determine pharmacokinetics, drug disposition and interpopulation variability of oral amoxicillin in this demographic. METHODS: Young infants with signs of sepsis enrolled in an oral amoxicillin/intramuscular gentamicin treatment arm of a sepsis trial in Karachi, Pakistan, were studied. Limited pharmacokinetic (PK) sampling was performed at 0, 2-3 and 6-8 hours following an index dose of oral amoxicillin. Plasma concentrations were determined by high-performance liquid chromatography/mass spectrometry. Values of ≥2 mg/L were considered as the effect threshold, given the regional minimal inhibitory concentration (MIC) of resistant Streptococcus pneumoniae. RESULTS: Amoxicillin concentrations were determined in 129 samples from 60 young infants. Six of 44 infants had positive blood cultures with predominant Gram-positive organisms. Forty-four infants contributing blood at ≥2 of 3 specified timepoints were included in the analysis. Mean amoxicillin levels at 2-3 hours (11.6±9.5 mg/L, n=44) and 6-8 hours (16.4±9.3 mg/L, n=20) following the index dose exceeded the MIC for amoxicillin (2.0 mg/L) against resistant S. pneumoniae strains. Of 20 infants with three serum levels, 7 showed a classic dose-exposure profile and 13 showed increasing concentrations with time, implying delayed absorption or excretion. CONCLUSION: Amoxicillin concentrations in sera of young infants following oral administration at 75-100 mg/kg/day daily divided doses exceeds the susceptibility breakpoint for >50% of a 12-hour dosing interval.Oral amoxicillin may hold potential as a safe replacement of parenteral ampicillin in newborn sepsis regimens, including aminoglycosides, where hospitalisation is not feasible. TRIAL REGISTRATION NUMBER: NCT01027429.


Assuntos
Amoxicilina/sangue , Amoxicilina/farmacocinética , Antibacterianos/sangue , Antibacterianos/farmacocinética , Sepse/tratamento farmacológico , Administração Oral , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Quimioterapia Combinada , Feminino , Gentamicinas/administração & dosagem , Humanos , Lactente , Recém-Nascido , Injeções Intramusculares , Masculino , Testes de Sensibilidade Microbiana , Streptococcus pneumoniae/efeitos dos fármacos , Fatores de Tempo
5.
J Vet Pharmacol Ther ; 43(4): 307-312, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32112576

RESUMO

The aim of the present study was to elucidate the pharmacokinetic profiles of amoxicillin trihydrate (AMX) in Siamese freshwater crocodiles (Crocodylus siamensis). Crocodiles were administered a single intramuscular injection of AMX, at a dose of either 5 or 10 mg/kg body weight (b.w.). Blood samples were collected at preassigned times up to 120 hr. The plasma concentrations of AMX were measured using a validated liquid chromatography tandem-mass spectrometry method. AMX plasma concentrations were quantifiable for up to 72 hr (5 mg/kg b.w.) and 96 hr (10 mg/kg b.w.). The elimination half-life (t1/2λ z ) of AMX following dosing at 5 mg/kg b.w. (8.72 ± 0.61 hr) was almost identical to that following administration at 10 mg/kg b.w (8.98 ± 1.13 hr). The maximum concentration and area under the curve from zero to the last values of AMX increased in a dose-dependent fashion. The average binding percentage of AMX to plasma protein was 21.24%. Based on the pharmacokinetic data, susceptibility break point, and the surrogate PK-PD index (T > MIC, 0.25 µg/ml), intramuscular administration of AMX at dose of 5 mg/kg b.w. every 4 days might be appropriate for the treatment of susceptible bacterial infections in freshwater crocodiles.


Assuntos
Jacarés e Crocodilos/metabolismo , Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Jacarés e Crocodilos/sangue , Amoxicilina/administração & dosagem , Amoxicilina/sangue , Animais , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Área Sob a Curva , Esquema de Medicação , Água Doce , Meia-Vida , Injeções Intramusculares/veterinária , Masculino , Distribuição Aleatória
6.
J Vet Pharmacol Ther ; 43(2): 115-122, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31183878

RESUMO

Amoxicillin was administered as a single subcutaneous injection at 12.5 mg/kg to four koalas and changes in amoxicillin plasma concentrations over 24 hr were quantified. Amoxicillin had a relatively low average ± SD maximum plasma concentration (Cmax ) of 1.72 ± 0.47 µg/ml; at an average ± SD time to reach Cmax (Tmax ) of 2.25 ± 1.26 hr, and an elimination half-life of 4.38 ± 2.40 hr. The pharmacokinetic profile indicated relatively poor subcutaneous absorption. A metabolite was also identified, likely associated with glucuronic acid conjugation. Bacterial growth inhibition assays demonstrated that all plasma samples other than t = 0 hr, inhibited the growth of Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 29213 to some extent. Calculated pharmacokinetic indices were used to predict whether this dose could attain a plasma concentration to inhibit some susceptible Gram-negative and Gram-positive pathogens. It was predicted that a twice daily dose of 12.5 mg/kg would be efficacious to inhibit susceptible bacteria with an amoxicillin minimum inhibitory concentration (MIC) ≤ 0.75 µg/ml such as susceptible Bordetella bronchiseptica, E. coli, Staphylococcus spp. and Streptococcus spp. pathogens.


Assuntos
Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Phascolarctidae/metabolismo , Amoxicilina/administração & dosagem , Amoxicilina/sangue , Animais , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Área Sob a Curva , Proteínas Sanguíneas/metabolismo , Cromatografia Líquida/veterinária , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Feminino , Glucuronídeos/metabolismo , Meia-Vida , Injeções Subcutâneas/veterinária , Masculino , Espectrometria de Massas/veterinária , Ligação Proteica , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento
7.
J Chromatogr A ; 1611: 460611, 2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-31627968

RESUMO

This study presents the development of an efficient extraction protocol for amoxicillin from plasma with improved solubility and stability using pH control. Solubility and stability of amoxicillin in commonly used extraction solvents were determined using a newly developed stability-indicating high-performance liquid chromatography (HPLC) method. Following this, protein precipitation (PP) mediated sample purification protocol was developed and validated along with the HPLC method for the extracted amoxicillin from rabbit plasma. The protocol was applied in a pharmacokinetic study in rabbits. A five-fold increase in solubility and two-fold increase in stability of amoxicillin was found by addition of acetate buffer (0.1 M, pH 5.0) in acetonitrile. PP mediated extraction protocol containing acetate buffer-acetonitrile (1:18 v/v) resulted in an extraction recovery of >80% for all the samples. The HPLC assay following extraction was found linear (R2   >0.9999) over the range of 0.2-20 µg/mL with a lower limit of quantification of 0.2 µg/mL. The accuracy of the quality control samples was found between 97-115% and the relative standard deviation (RSD) was found to be below 6% for all samples. The samples were stable in the mobile phase (pH 5.0) for 72 h post-extraction. Amoxicillin-spiked plasma samples were found stable for up to three freeze-and-thaw cycles but, nearly 50% samples had degraded following storage for two months at -20 °C. Pharmacokinetic analysis indicated a half-life of amoxicillin of nearly 1 h following intravenous injection in rabbits, which is similar to that in humans. Thus, a simple and repeatable, extraction protocol was developed using pH control for quantification of amoxicillin from plasma based on its physicochemical properties.


Assuntos
Amoxicilina/sangue , Amoxicilina/isolamento & purificação , Cromatografia Líquida de Alta Pressão/métodos , Amoxicilina/farmacocinética , Animais , Humanos , Cinética , Coelhos , Reprodutibilidade dos Testes , Solubilidade , Solventes
8.
BMC Pharmacol Toxicol ; 20(1): 54, 2019 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470904

RESUMO

BACKGROUND: The investigation of food-drug and plant-drug interactions has become increasingly important. In case of antibiotics, it is essential to achieve and maintain a plasma concentration sufficient for the antimicrobial action. Although, on theoretical basis, the interaction of polyphenols and antibiotics may be hypothesized, experimental data are lacking to assess its clinical relevance. The aim of our study was to assess the interaction between one of the most widely used antibiotics, amoxicillin, and green tea, the most frequently consumed drink with high polyphenol content. METHODS: The effects of green tea on the plasma level of amoxicillin was studied in an in vivo experiment in rats. The plasma level of amoxicillin was monitored by LC-MS/MS for 240 min after oral administration. The polyphenol content of green tea was determined by the Folin-Ciocalteu method. RESULTS: The peak plasma concentration of amoxicillin significantly decreased upon its co-administration with green tea, although the AUC0-240 of the antibiotic did not decrease significantly in the group treated with amoxicillin suspended in green tea. CONCLUSIONS: Our results suggest a potentially relevant interaction between green tea and amoxicillin, worth being further studied in humans.


Assuntos
Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Absorção Intestinal , Chá , Amoxicilina/sangue , Animais , Antibacterianos/sangue , Cromatografia Líquida , Masculino , Polifenóis/análise , Ratos , Ratos Wistar , Espectrometria de Massas em Tandem , Chá/química
9.
J Pharm Biomed Anal ; 174: 256-262, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31181488

RESUMO

A rapid and highly sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) assay was developed for quantification of 7 antibiotics in low sample volumes (50 µL): amoxicillin, azithromycin, cefotaxime, ciprofloxacin, meropenem, metronidazole and piperacillin, for both routine monitoring and pharmacokinetic studies. After protein precipitation by acetonitrile, the antibiotics were separated on an Acquity UPLC HSS T3 column (run time, 4 min). The mobile phase consisted of a mixture of (A) ammonium acetate (pH 2.4; 5 mM) and (B) acetonitrile acidified with 0.1% formic acid, delivered at 500 µl/min in a gradient elution mode. Total time run was 2.75 min. Ions were detected in the turbo-ion-spray-positive and multiple-reaction-monitoring modes. The assay was accurate and reproductible for the quantification of the seven antibiotics in serum samples over large concentration ranges.


Assuntos
Antibacterianos/sangue , Análise Química do Sangue/métodos , Cromatografia Líquida de Alta Pressão/métodos , Espectrometria de Massas em Tandem/métodos , Adolescente , Amoxicilina/sangue , Azitromicina/sangue , Calibragem , Cefotaxima/sangue , Criança , Pré-Escolar , Ciprofloxacina/sangue , Infecções por Escherichia coli/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/microbiologia , Limite de Detecção , Masculino , Meropeném/sangue , Metronidazol/sangue , Pediatria , Piperacilina/sangue , Reprodutibilidade dos Testes
10.
Br J Clin Pharmacol ; 85(9): 2118-2125, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31215676

RESUMO

AIMS: To evaluate the relative bioavailability of oral amoxicillin (AMX) tablets in comparison to AMX suspension in Roux-en-Y gastric bypass bariatric subjects. METHODS: A randomized, double-blind, cross-over study was performed on the bioavailability of oral AMX tablets and suspension in Roux-en-Y gastric bypass subjects operated at least 3 months previously . Doses of 875 mg of the AMX tablet or 800 mg of the AMX suspension were given to all the subjects, allowing a washout of 7 days between the periods. Blood samples were collected at 0, 0.25, 0.5, 1, 1.5, 2, 4, 6 and 8 hours after drug administration and the AMX levels were quantified by liquid chromatography coupled with triple quadrupole tandem mass spectrometry. The pharmacokinetic parameters were calculated by noncompartmental analysis, normalized to an 875 mg dose and the bioavailability of the AMX from the tablets was compared to that from the suspension formulation. RESULTS: Twenty subjects aged 42.65 ± 7.21 years and with a body mass index of 29.88 ± 4.36 kg/m2 were enrolled in the study. The maximum AMX plasma concentration of the tablets and the suspension (normalized to 875 mg) were 7.42 ± 2.99 mg/L and 8.73 ± 3.26 mg/L (90% confidence interval of 70.71-99.11), and the total area under the curve from time zero to infinity were 23.10 ± 7.41 mg.h/L and 27.59 ± 8.32 mg.h/L (90% confidence interval of 71.25-97.32), respectively. CONCLUSION: The tablets presented a lower bioavailability than the suspension formulation and the total absorbed amount of AMX in these subjects was lower in comparison to the standard AMX absorption rates in nonbariatric subjects, regardless of the formulation.


Assuntos
Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Derivação Gástrica/efeitos adversos , Administração Oral , Adulto , Amoxicilina/administração & dosagem , Amoxicilina/sangue , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Área Sob a Curva , Disponibilidade Biológica , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suspensões , Comprimidos
11.
Talanta ; 201: 253-258, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31122420

RESUMO

To assess pharmacokinetics of amoxicillin (AMX) in mice, limitations such as a small sampling volume and low drug concentrations have to be addressed. Similar challenges are faced in a clinical framework, e.g. for therapeutic drug monitoring in neonates or small-scale in vitro investigations. An assay enabling quantification of small sample volumes but still at very low concentrations covering a broad concentration range is thus needed. A simple, rapid and highly sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed and successfully validated for quantification of AMX in mouse serum according to European Medicines Agency guidelines. Sample preparation enabled the use of only 10 µL of serum, which is 5-fold less than comparable assays and allows to reduce the number of mice used in pharmacokinetic studies. After protein precipitation with 40 µL chilled methanol and dilution of the supernatant with water, the sample was injected into the LC system on a Poroshell 120 Phenyl Hexyl column (2.1 × 100 mm, 2.7 µm). Chromatographic separation was achieved using a gradient method consisting of acetonitrile and ultra-pure water, both with 0.1% (V/V) formic acid. Positive electrospray ionisation in multiple reaction monitoring mode was used for detection and quantification of AMX. Application to murine study samples demonstrated the reliability of the developed method being accurate and precise with a quantification range from 0.01 to 10 µg/mL. The assay is easily transferable due to a simple sample preparation and confirmed stability of AMX under various applied conditions.


Assuntos
Amoxicilina/sangue , Cromatografia Líquida/métodos , Espectrometria de Massas em Tandem/métodos , Animais , Calibragem , Limite de Detecção , Camundongos
12.
J Vet Pharmacol Ther ; 42(1): 45-51, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30218459

RESUMO

This study was conducted to determine the passage ratio of amoxicillin into milk and its pharmacokinetics in milk and plasma after intramuscular administration. Five healthy dairy cows (Holstein, weighing 450-500 kg, aged 2-4 years) were used in this study. They received single intramuscular amoxicillin at a dose of 14 mg/kg body weight. Blood and milk samples were collected prior to drug administration (0); after 15, 30, 45, 60, and 90 min; and 2, 3, 4, 6, 8, 10, and 12 hr after administration. The plasma and milk concentrations of amoxicillin were determined using high-performance liquid chromatography with ultraviolet detection. The passage ratio of amoxicillin into milk and plasma was determined using both AUC-based calculation and milk and plasma concentrations at sampling times; it was calculated 0.46 and 0.52, respectively. The terminal half-life and mean residence time of amoxicillin were 6.05 and 8.60 hr in plasma and 2.62 and 5.35 hr in milk, respectively. The Cmax2 levels of amoxicillin in plasma and milk were measured as 1,096 and 457 ng/ml, respectively. It was observed that amoxicillin exhibited a secondary peak in plasma and milk. This study was the first to report on the passage ratio of amoxicillin into milk in lactating cows.


Assuntos
Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Leite/química , Amoxicilina/administração & dosagem , Amoxicilina/análise , Amoxicilina/sangue , Animais , Antibacterianos/administração & dosagem , Antibacterianos/análise , Antibacterianos/sangue , Bovinos/sangue , Bovinos/metabolismo , Cromatografia Líquida de Alta Pressão/veterinária , Feminino , Meia-Vida , Injeções Intramusculares/veterinária
13.
Chemotherapy ; 64(4): 173-176, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31940615

RESUMO

Dosing of amoxicillin-clavulanic acid in critical illness is difficult as ß-lactam pharmacokinetics are altered by physiological changes and therapies initiated in the intensive care unit such as renal replacement therapy (RRT). Successful treatment relies on sustaining a free antibiotic concentration above the minimum inhibitory concentration of the target pathogen (fT>MIC). We present a case of a patient treated with amoxicillin-clavulanic acid (1.2 g for 8 h) for an aspiration pneumonia. Dosing in this case was complicated by the necessity for RRT to treat a drug overdose with carbamazepine, despite normal native renal function. Antibiotic concentrations taken at steady state revealed a clearance of 14.6 L/h and a low fT>MIC (<40%). Analysis of the urine drug concentration suggested that 48% of clearance was via the native kidneys. This case illustrates that careful consideration of antibiotic dose and frequency is required in critically ill patients receiving RRT and highlights the need for further research in this patient group. In future similar cases, we would consider a dose of 2.2 g 6- or 8-hourly with early therapeutic drug monitoring.


Assuntos
Amoxicilina/uso terapêutico , Ácido Clavulânico/uso terapêutico , Hemodiafiltração , Pneumonia/tratamento farmacológico , Adulto , Consumo de Bebidas Alcoólicas , Amoxicilina/sangue , Cromatografia Líquida de Alta Pressão , Meia-Vida , Humanos , Unidades de Terapia Intensiva , Rim/fisiologia , Klebsiella pneumoniae/isolamento & purificação , Masculino , Espectrometria de Massas , Polimedicação , Escarro/microbiologia , Staphylococcus aureus/isolamento & purificação
14.
Obes Surg ; 29(3): 917-927, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30415354

RESUMO

BACKGROUND: Bariatric surgery leads to several anatomo-physiological modifications that may affect pharmacokinetic parameters and consequently alter the therapeutic effect of drugs, such as antibiotics. The pharmacokinetics of oral amoxicillin after Roux-en-Y gastric bypass (RYGB) surgery is unknown. OBJECTIVES: The objective of this study was to evaluate the impact of bariatric surgery on the pharmacokinetics of amoxicillin. METHODS: This study was performed as a randomized, open-label, single-dose clinical trial, with two periods of treatment, in which obese subjects (n = 8) received an amoxicillin 500 mg capsule orally before and 2 months after the RYGB surgery. The amoxicillin plasma concentration was determined by liquid chromatography coupled to mass spectrometry (LC-MS/MS). RESULTS: After the surgery, the mean weight loss was 17.03 ± 5.51 kg, and mean body mass index (BMI) decreased from 46.21 ± 2.82 to 38.82 ± 3.32 kg/m2. The mean amoxicillin area under the plasma concentration versus time curve from time zero to the time of the last quantifiable concentration (AUC0-tlast) increased significantly (3.5-fold); the maximum plasma concentration (Cmax) increased 2.8-fold after the bariatric surgery. No correlation was found between amoxicillin absorption, BMI, and weight loss percentage. CONCLUSION: The alterations observed in the amoxicillin pharmacokinetics suggest that obese subjects included in this trial had a substantially increase in amoxicillin systemic exposure after RYGB surgery. However, despite this increase, its exposure was lower than the values reported for non-obese volunteers. TRIAL REGISTRATION: Identifiers: NCT03588273.


Assuntos
Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Derivação Gástrica , Obesidade Mórbida/metabolismo , Obesidade Mórbida/cirurgia , Redução de Peso/fisiologia , Administração Oral , Adulto , Amoxicilina/administração & dosagem , Amoxicilina/sangue , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Índice de Massa Corporal , Cromatografia Líquida , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/sangue , Espectrometria de Massas em Tandem
15.
Res Vet Sci ; 123: 47-50, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30586651

RESUMO

Treatment of mink kits with pre-weaning diarrhea (PWD) can be time-consuming and expensive for the farmer, and the efficacy of the treatment procedure may be questioned. Evidence-based treatment protocols for application on affected animals at farms with outbreaks of PWD are lacking. In Denmark, the dams are sometimes treated with amoxicillin, however, it is unknown if it is passed on to the mink kits via the milk. The aim of the present study was to investigate if amoxicillin is transferred via the milk to the kits after oral (PO) and intramuscular (IM) treatment, respectively, of the dam. Moreover, we estimated the concentrations of amoxicillin continuously in serum from the kits up to 8 h after administration. The concentration of amoxicillin was not affected by the route of administration (P = .64) and serum reached the highest level after 8 h (34 ng/mL, CI95% = [24.3-47.7]). The serum concentrations of amoxicillin in the mink kits achieved within 8 h were judged too low to exert antimicrobial impact on relevant bacterial species.


Assuntos
Amoxicilina/farmacocinética , Animais Lactentes/metabolismo , Antibacterianos/farmacocinética , Leite/química , Vison/metabolismo , Administração Oral , Amoxicilina/sangue , Criação de Animais Domésticos , Animais , Antibacterianos/sangue , Cromatografia Líquida , Feminino , Injeções Intramusculares/veterinária
16.
Artigo em Inglês | MEDLINE | ID: mdl-29775840

RESUMO

A method was developed for the determination of amoxicillin and metronidazole in human serum. The procedure used was hydrophilic interaction chromatography (HILIC) followed by mass spectrometric (MS) detection. Chromatographic separation was achieved on a ZIC-HILIC column and the mobile phase consisted of a mixture of 0.1% (v/v) formic acid in water and 0.1% (v/v) formic acid in acetonitrile. The method was validated with regard to selectivity, accuracy, precision, calibration, lower limit of quantification (LOQ), extraction recovery and matrix effect. The LOQs were 0.0138 and 0.008 µg/ml for amoxicillin and metronidazole respectively, while for quantification purposes linearity was achieved in the range of 0.1 µg/ml to 6.4 µg/ml for both drugs with correlation coefficients >0.9990. The intraday precision (expressed as %RSD) and the accuracy (expressed as the % deviation from the nominal value) was <15% for both antibiotics at all QC levels. Extraction recoveries for both drugs and internal standards were >80%, while a considerable matrix effect (<60%) was observed for amoxicillin. Finally, the method was applied to the determination of amoxicillin and metronidazole concentrations in serum for 20 patients.


Assuntos
Amoxicilina/sangue , Antibacterianos/sangue , Metronidazol/sangue , Espectrometria de Massas em Tandem/métodos , Acetonitrilas/química , Calibragem , Cromatografia Líquida/métodos , Humanos , Interações Hidrofóbicas e Hidrofílicas , Limite de Detecção , Reprodutibilidade dos Testes , Soro
17.
Eur J Clin Pharmacol ; 74(9): 1149-1157, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29846770

RESUMO

PURPOSE: Ilaprazole, the latest proton pump inhibitor, can be used with clarithromycin and amoxicillin as a triple therapy regimen for eradicating Helicobacter pylori. The aim of this study was to evaluate pharmacokinetic drug interactions and safety profiles after coadministration of clarithromycin, amoxicillin, and ilaprazole. METHODS: A randomised, open-label, one-way crossover, two parallel sequences study was conducted in 32 healthy subjects. In part 1, the subjects received a single dose of ilaprazole 10 mg in period 1 and clarithromycin 500 mg and amoxicillin 1000 mg twice daily for 6 days in period 2. In part 2, the subjects received clarithromycin 500 mg and amoxicillin 1000 mg once in period 1 and ilaprazole 10 mg twice daily for 6 days in period 2. In both sequences, the three drugs were coadministrated once on day 5 in period 2. Pharmacokinetic evaluations of ilaprazole (part 1), and clarithromycin and amoxicillin (part 2) were conducted. RESULTS: Twenty-eight subjects completed the study. For ilaprazole, the peak concentration (Cmax) slightly decreased from 479 (ilaprazole alone) to 446 ng/mL (triple therapy) [Geometric least square mean ratio (90% confidence interval), 0.93 (0.70-1.22)]. The area under the concentration-time curve from 0 h to the last measurable concentration (AUClast) slightly increased from 3301 to 3538 µg·h/mL [1.07 (0.85-1.35)]. For clarithromycin, the Cmax slightly decreased from 1.87 to 1.72 µg/mL [0.90 (0.70-1.15)], and AUClast slightly increased from 14.6 to 16.5 µg·h/mL [1.09 (0.87-1.37)]. For amoxicillin, the Cmax slightly decreased from 9.37 to 8.14 µg/mL [0.86 (0.74-1.01)], and AUClast slightly decreased from 27.9 to 26.7 µg·h/mL [0.98 (0.83-1.16)]. These changes in the PK parameters of each drug were not statistically significant. CONCLUSIONS: The coadministration of ilaprazole, clarithromycin, and amoxicillin was tolerable and did not cause a significant PK drug interaction. Thus, a triple therapy regimen comprising ilaprazole, clarithromycin, and amoxicillin may be an option for the eradication of H. pylori. Clinicaltrials.gov number: NCT02998437.


Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/farmacocinética , Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Claritromicina/farmacocinética , Inibidores da Bomba de Prótons/farmacocinética , 2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , 2-Piridinilmetilsulfinilbenzimidazóis/efeitos adversos , 2-Piridinilmetilsulfinilbenzimidazóis/sangue , Adulto , Amoxicilina/administração & dosagem , Amoxicilina/efeitos adversos , Amoxicilina/sangue , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Antibacterianos/sangue , Claritromicina/administração & dosagem , Claritromicina/efeitos adversos , Claritromicina/sangue , Estudos Cross-Over , Interações Medicamentosas , Quimioterapia Combinada , Voluntários Saudáveis , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Inibidores da Bomba de Prótons/administração & dosagem , Inibidores da Bomba de Prótons/efeitos adversos , Inibidores da Bomba de Prótons/sangue , República da Coreia , Medição de Risco , Adulto Jovem
19.
J Vet Pharmacol Ther ; 41(4): 588-598, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29604071

RESUMO

Amoxicillin is used in the treatment and prevention of a wide range of diseases in poultry breeding. However, its short half-life and low bioavailability restrict its clinical application in these species. Entrapment of drugs into polymeric nanoparticles (nps) presents a means to improve gastrointestinal absorption and oral bioavailability of drugs. This study was aimed to overcome limitation of amoxicillin use in poultry breeding. Amoxicillin was loaded into sodium alginate-polyvinyl alcohol (NaAlg-PVA) blend nps, and characterization of the prepared nps was performed. For pharmacokinetic study, commercial male broilers were used and comparative pharmacokinetics of free and nanoparticle form of amoxicillin were investigated. Twenty-one broilers were divided into three groups. All groups received 10 mg/kg drug. Blood samples were collected, and drug plasma concentrations were determined by HPLC. The results demonstrated that the particle size, zeta potential, encapsulation efficiency, and loading capacity of the nps were 513.96 ± 19.46 nm, -45.36 ± 1.35 mV, 43.66 ± 3.30, and 12.06 ± 0.83%, respectively. In vitro drug release exhibited a biphasic pattern with an initial burst release of 18% within 2 hr followed by a sustained release over 22 hr. The pharmacokinetic results showed that amoxicillin nps have higher bioavailability and longer plasma half-life (p < .01) than free amoxicillin. These results indicate that amoxicillin nano formulation is suitable for oral administration in broilers.


Assuntos
Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Sistemas de Liberação de Medicamentos/veterinária , Nanopartículas/administração & dosagem , Alginatos/química , Amoxicilina/sangue , Amoxicilina/farmacocinética , Animais , Antibacterianos/sangue , Antibacterianos/farmacocinética , Disponibilidade Biológica , Galinhas/sangue , Galinhas/metabolismo , Preparações de Ação Retardada , Sistemas de Liberação de Medicamentos/métodos , Ácido Glucurônico/química , Meia-Vida , Ácidos Hexurônicos/química , Masculino , Nanopartículas/química , Álcool de Polivinil/química
20.
Artigo em Inglês | MEDLINE | ID: mdl-29084754

RESUMO

Penicillins are widely used to treat infections in children; however, the evidence is continuing to evolve in defining the optimal dosing. Modern pediatric pharmacokinetic study protocols frequently favor opportunistic, "scavenged" sampling. This study aimed to develop a small-volume single assay for five major penicillins and to assess the influence of sample degradation on inferences made using pharmacokinetic modeling, to investigate the suitability of scavenged sampling strategies. Using a rapid ultrahigh-performance liquid chromatographic-tandem mass spectrometric method, an assay for five penicillins (amoxicillin, ampicillin, benzylpenicillin, piperacillin, and flucloxacillin) in blood plasma was developed and validated. Penicillin stabilities were evaluated under different conditions. Using these data, the impact of drug degradation on inferences made during pharmacokinetic modeling was evaluated. All evaluated penicillins indicated good stability at room temperature (23 ± 2°C) over 1 h, remaining in the range of 98 to 103% of the original concentration. More-rapid analyte degradation had already occurred after 4 h, with stability ranging from 68% to 99%. Stability over longer periods declined: degradation of up to 60% was observed with delayed sample processing of up to 24 h. Modeling showed that analyte degradation can lead to a 30% and 28% bias in clearance and volume of distribution, respectively, and falsely show nonlinearity in clearance. Five common penicillins can now be measured in a single low-volume blood sample. Beta-lactam chemical instability in plasma can cause misleading pharmacokinetic modeling results, which could impact upon model-based dosing recommendations and the forthcoming era of beta-lactam therapeutic drug monitoring.


Assuntos
Amoxicilina/sangue , Ampicilina/sangue , Antibacterianos/sangue , Floxacilina/sangue , Penicilina G/sangue , Piperacilina/sangue , Cromatografia Líquida de Alta Pressão , Estabilidade de Medicamentos , Humanos , Espectrometria de Massas em Tandem
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