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1.
AAPS PharmSciTech ; 22(5): 170, 2021 Jun 03.
Article in English | MEDLINE | ID: mdl-34085150

ABSTRACT

A novel nanofiber insert was prepared with a modified electrospinning method to enhance the ocular residence time of ofloxacin (OFX) and to provide a sustained release pattern by covering hydrophilic polymers, chitosan/polyvinyl alcohol (CS/PVA) nanofibers, with a hydrophobic polymer, Eudragit RL100 in layers, and by glutaraldehyde (GA) cross-linking of CS-PVA nanofibers for the treatment of infectious conjunctivitis. The morphology of the prepared nanofibers was studied using scanning electron microscopy (SEM). The average fiber diameter was found to be 123 ± 23 nm for the single electrospun nanofiber with no cross-linking (OFX-O). The single nanofibers, cross-linked for 10 h with GA (OFX-OG), had an average fiber diameter of 159 ± 30 nm. The amount of OFX released from the nanofibers was measured in vitro and in vivo using UV spectroscopy and microbial assay methods against Staphylococcus aureus, respectively. The antimicrobial efficiency of OFX formulated in cross-linked and non-cross-linked nanofibers was affirmed by observing the inhibition zones of Staphylococcus aureus and Escherichia coli. In vivo studies using the OFX nanofibrous inserts on a rabbit eye confirmed a sustained release pattern for up to 96 h. It was found that the cross-linking of the nanofibers by GA vapor could reduce the burst release of OFX from OFX-loaded CS/PVA in one layer and multi-layered nanofibers. In vivo results showed that the AUC0-96 for the nanofibers was 9-20-folds higher compared to the OFX solution. This study thus demonstrates the potential of the nanofiber technology is being utilized to sustained drug release in ocular drug delivery systems.


Subject(s)
Acrylic Resins/chemistry , Administration, Ophthalmic , Chitosan/chemistry , Nanofibers/chemistry , Ofloxacin/chemistry , Polyvinyl Alcohol/chemistry , Acrylic Resins/administration & dosage , Acrylic Resins/pharmacokinetics , Animals , Anti-Bacterial Agents/chemistry , Chemistry, Pharmaceutical/methods , Chitosan/administration & dosage , Chitosan/pharmacokinetics , Delayed-Action Preparations/administration & dosage , Delayed-Action Preparations/chemistry , Delayed-Action Preparations/pharmacokinetics , Drug Delivery Systems/methods , Drug Evaluation, Preclinical/methods , Escherichia coli/drug effects , Escherichia coli/physiology , Nanofibers/administration & dosage , Ofloxacin/administration & dosage , Ofloxacin/pharmacokinetics , Polyvinyl Alcohol/administration & dosage , Polyvinyl Alcohol/pharmacokinetics , Rabbits , Staphylococcus aureus/drug effects , Staphylococcus aureus/physiology
2.
Article in English | MEDLINE | ID: mdl-31061152

ABSTRACT

Fluoroquinolones are group A drugs in tuberculosis guidelines. We aim to compare the culture conversion between new-generation (levofloxacin and moxifloxacin) and old-generation (ciprofloxacin and ofloxacin) fluoroquinolones, develop pharmacokinetic models, and calculate target attainment for levofloxacin and moxifloxacin. We included three U.S. tuberculosis centers. Patients admitted between 1984 and 2015, infected with drug-resistant tuberculosis, and who had received fluoroquinolones for ≥28 days were included. Demographics, sputum cultures and susceptibility, treatment regimens, and serum concentrations were collected. A time-to-event analysis was conducted, and Cox proportional hazards model was used to compare the time to culture conversion. Using additional data from ongoing studies, pharmacokinetic modelling and Monte Carlo simulations were performed to assess target attainment for different doses. Overall, 124 patients received fluoroquinolones. The median age was 40 years, and the median weight was 60 kg. Fifty-six patients (45%) received old-generation fluoroquinolones. New-generation fluoroquinolones showed a faster time to culture conversion (median 16 versus 40 weeks, P = 0.012). After adjusting for isoniazid and clofazimine treatment, patients treated with new-generation fluoroquinolones were more likely to have culture conversion (adjusted hazards ratio, 2.16 [95% confidence interval, 1.28 to 3.64]). We included 178 patients in the pharmacokinetic models. Levofloxacin and moxifloxacin were best described by a one-compartment model with first-order absorption and elimination. At least 1,500 to 1,750 mg levofloxacin and 800 mg moxifloxacin may be needed for maximum kill at the current epidemiologic cutoff values. In summary, new-generation fluoroquinolones showed faster time to culture conversion compared to the old generation. For optimal target attainment at the current MIC values, higher doses of levofloxacin and moxifloxacin may be needed.


Subject(s)
Antitubercular Agents/administration & dosage , Antitubercular Agents/pharmacokinetics , Fluoroquinolones/pharmacokinetics , Tuberculosis, Multidrug-Resistant/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Ciprofloxacin/pharmacokinetics , Dose-Response Relationship, Drug , Female , Fluoroquinolones/administration & dosage , Humans , Levofloxacin/administration & dosage , Levofloxacin/pharmacokinetics , Male , Microbial Sensitivity Tests , Middle Aged , Models, Biological , Moxifloxacin/administration & dosage , Moxifloxacin/pharmacokinetics , Ofloxacin/pharmacokinetics , Retrospective Studies , Tuberculosis, Multidrug-Resistant/microbiology , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiology , Young Adult
3.
AAPS PharmSciTech ; 20(5): 183, 2019 May 03.
Article in English | MEDLINE | ID: mdl-31054011

ABSTRACT

This study aims to investigate whether modification of solid lipid nanoparticles (SLNs) with chitosan (CTS) and polyethylene glycol (PEG) coatings enhances corneal retention time and transcorneal bioavailability. Ofloxacin (OFLOX) was selected as the model drug because of its potential benefits for the treatment of local eye infections. The OFLOX-CTS-PEG-SLN was prepared by a modified emulsion/solvent evaporation technique. A central composite design was implemented to investigate the influence of total lipid/drug ratio, surfactant concentration, PEG stearate concentration in the lipid mixture, and CTS concentration on size, entrapment, transcorneal permeation, and adhesion to the corneal mucosal membrane. The optimized OFLOX-CTS-PEG-SLN was characterized for OFLOX cumulative percentage released in simulated tear fluid and permeated across the excised bovine corneal membrane. Moreover, nanoparticle morphology, eye irritation via histopathological analysis, and OFLOX concentration in the ocular fluids and tissues were determined. A total lipid/drug ratio of 19:1, Tween 80 of 2%, PEG stearate concentration in the lipid mixture (% w/w) of 2.6%, and CTS concentration (% w/v) of 0.23% produced 132.9 nm particles entrapping 74.8% of the total drug added. The particles detached from the corneal membrane at a force of 3700 dyne/cm2. The %OFLOX released from the optimized nanoparticles was 63.3, and 66% of the drug permeated after 24 h. Compared to Oflox® drops, the optimized OFLOX-CTS-PEG-SLN exhibited similar tolerability but two- to threefold higher concentrations in the eyes of rabbits. Coating of SLN with chitosan and PEG augments the ocular bioavailability of OFLOX by increasing transcorneal permeation and enhancing mucoadhesion strength.


Subject(s)
Anti-Infective Agents/administration & dosage , Ofloxacin/administration & dosage , Administration, Ophthalmic , Animals , Anti-Infective Agents/adverse effects , Anti-Infective Agents/pharmacokinetics , Biological Availability , Biopharmaceutics , Cattle , Chitosan , Drug Compounding , Drug Delivery Systems , Irritants , Lipids/chemistry , Male , Nanoparticles , Ofloxacin/adverse effects , Ofloxacin/pharmacokinetics , Polyethylene Glycols , Rabbits
4.
Article in English | MEDLINE | ID: mdl-29038275

ABSTRACT

Antimicrobial resistance among uropathogens has increased the rates of infection-related morbidity and mortality. Antofloxacin is a novel fluoroquinolone with broad-spectrum antibacterial activity against urinary Gram-negative bacilli, such as Escherichia coli This study monitored the in vivo efficacy of antofloxacin using bioluminescent imaging and determined pharmacokinetic (PK)/pharmacodynamic (PD) targets against E. coli isolates in a neutropenic murine thigh infection model. The PK properties were determined after subcutaneous administration of antofloxacin at 2.5, 10, 40, and 160 mg/kg of body weight. Following thigh infection, the mice were treated with 2-fold-increasing doses of antofloxacin from 2.5 to 80 mg/kg administered every 12 h. Efficacy was assessed by quantitative determination of the bacterial burdens in thigh homogenates and was compared with the bioluminescent density. Antofloxacin demonstrated both static and killing endpoints in relation to the initial burden against all study strains. The PK/PD index area under the concentration-time curve (AUC)/MIC correlated well with efficacy (R2 = 0.92), and the dose-response relationship was relatively steep, as observed with escalating doses of antofloxacin. The mean free drug AUC/MIC targets necessary to produce net bacterial stasis and 1-log10 and 2-log10 kill for each isolate were 38.7, 66.1, and 147.0 h, respectively. In vivo bioluminescent imaging showed a rapid decrease in the bioluminescent density at free drug AUC/MIC exposures that exceeded the stasis targets. The integration of these PD targets combined with the results of PK studies with humans will be useful in setting optimal dosing regimens for the treatment of urinary tract infections due to E. coli.


Subject(s)
Anti-Bacterial Agents/pharmacology , Escherichia coli Infections/drug therapy , Escherichia coli/drug effects , Neutropenia/microbiology , Ofloxacin/analogs & derivatives , Animals , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacokinetics , Disease Models, Animal , Dose-Response Relationship, Drug , Drug Evaluation, Preclinical/methods , Escherichia coli/genetics , Escherichia coli/isolation & purification , Female , Half-Life , Mice, Inbred ICR , Microbial Sensitivity Tests , Ofloxacin/administration & dosage , Ofloxacin/pharmacokinetics , Ofloxacin/pharmacology , Plasmids/genetics , Soft Tissue Infections/drug therapy , Soft Tissue Infections/microbiology , Thigh/microbiology
5.
Article in English | MEDLINE | ID: mdl-30249697

ABSTRACT

Short-course regimens for multidrug-resistant tuberculosis (MDR-TB) are urgently needed. Limited data suggest that the new drug bedaquiline (BDQ) may have the potential to shorten MDR-TB treatment to less than 6 months when used in conjunction with standard anti-TB drugs. However, the feasibility of BDQ in shortening MDR-TB treatment duration remains to be established. Mathematical modeling provides a platform to investigate different treatment regimens and predict their efficacy. We developed a mathematical model to capture the immune response to TB inside a human host environment. This model was then combined with a pharmacokinetic-pharmacodynamic model to simulate various short-course BDQ-containing regimens. Our modeling suggests that BDQ could reduce MDR-TB treatment duration to just 18 weeks (4 months) while still maintaining a very high treatment success rate (100% for daily BDQ for 2 weeks, or 95% for daily BDQ for 1 week during the intensive phase). The estimated time to bacterial clearance of these regimens ranges from 27 to 33 days. Our findings provide the justification for empirical evaluation of short-course BDQ-containing regimens. If short-course BDQ-containing regimens are found to improve outcomes, then we anticipate clear cost savings and a subsequent improvement in the efficiency of national TB programs.


Subject(s)
Antitubercular Agents/pharmacology , Diarylquinolines/pharmacology , Host-Pathogen Interactions/drug effects , Macrophages/drug effects , Models, Statistical , Mycobacterium tuberculosis/drug effects , Antitubercular Agents/pharmacokinetics , Clofazimine/pharmacokinetics , Clofazimine/pharmacology , Colony Count, Microbial , Computer Simulation , Diarylquinolines/pharmacokinetics , Dose-Response Relationship, Drug , Drug Dosage Calculations , Drug Resistance, Bacterial/genetics , Drug Therapy, Combination , Ethambutol/pharmacokinetics , Ethambutol/pharmacology , Host-Pathogen Interactions/immunology , Humans , Immunity, Innate , Isoniazid/pharmacokinetics , Isoniazid/pharmacology , Kanamycin/pharmacokinetics , Kanamycin/pharmacology , Macrophages/immunology , Macrophages/microbiology , Microbial Sensitivity Tests , Moxifloxacin/pharmacokinetics , Moxifloxacin/pharmacology , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/growth & development , Mycobacterium tuberculosis/immunology , Ofloxacin/pharmacokinetics , Ofloxacin/pharmacology , Prothionamide/pharmacokinetics , Prothionamide/pharmacology , Pyrazinamide/pharmacokinetics , Pyrazinamide/pharmacology , Time Factors , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/immunology , Tuberculosis, Multidrug-Resistant/microbiology
6.
Ecotoxicol Environ Saf ; 156: 135-140, 2018 Jul 30.
Article in English | MEDLINE | ID: mdl-29549736

ABSTRACT

Fluoroquinolones (FQs) have attracted wide concerns due to their pseudo-persistent and universal presence in natural water. Here we exposed zebrafish separately to two FQs (enrofloxacin (ENR) and ofloxacin (OFL)) in different copper (Cu) concentrations for 20 days (d) in a flow-through system, followed by a 11 d depuration period in clean water to investigate compound specific bioaccumulation and tissue distribution. Two FQs could accumulate in zebrafish, and the high concentration was observed in liver. Moreover, the levels of FQs in different treatment groups were higher than the corresponding control fish group. The uptake rates (k1), elimination rates (k2), BCF value, and half-lives (t1/2) of FQs ranged from 0.02 to 3.28 d-1, 0.01 to 0.97 d-1, 0.33 to 109.33, 9.90 to 69.31 d, respectively. With Cu exposure concentration's increasing, k1 values in three tissues (liver, skin and gill) obviously decreased. The exposure concentration affected the BCF value significantly, but didn't change their relative compositions in liver, gill, skin, and muscle after long time exposure. BCF values of ENR were always a little bit higher than those of OFL in almost all the tissues (liver, skin and gill) in the low Cu concentration treatments, whereas, in the high Cu concentration treatments the bioconcentration factors (BCF) values of ENR were lower than the values of OFL. The exposure of Cu played an important role in the FQs bioconcentration and BCF. These results are meaningful for improved understanding and prediction of the behavior and fate of metallic and antibiotics in aqueous environments.


Subject(s)
Copper/toxicity , Fluoroquinolones/pharmacokinetics , Zebrafish , Animals , Anti-Bacterial Agents/pharmacokinetics , Dose-Response Relationship, Drug , Enrofloxacin , Gills/drug effects , Gills/metabolism , Liver/drug effects , Liver/metabolism , Muscle, Skeletal/drug effects , Muscle, Skeletal/metabolism , Ofloxacin/pharmacokinetics , Skin/drug effects , Skin/metabolism , Tissue Distribution
7.
Article in English | MEDLINE | ID: mdl-28264844

ABSTRACT

Antofloxacin is a novel broad-spectrum fluoroquinolone under development for the treatment of infections caused by a diverse group of bacterial species. We explored the pharmacodynamic (PD) profile and targets of antofloxacin against seven Klebsiella pneumoniae isolates by using a neutropenic murine lung infection model. Plasma and bronchopulmonary pharmacokinetic (PK) studies were conducted at single subcutaneous doses of 2.5, 10, 40, and 160 mg/kg of body weight. Mice were infected intratracheally with K. pneumoniae and treated using 2-fold-increasing total doses of antofloxacin ranging from 2.5 to 160 mg/kg/24 h administered in 1, 2, 3, or 4 doses. The Emax Hill equation was used to model the dose-response data. Antofloxacin could penetrate the lung epithelial lining fluid (ELF) with pharmacokinetics similar to those in plasma with linear elimination half-lives over the dose range. All study strains showed a 3-log10 or greater reduction in bacterial burden and prolonged postantibiotic effects (PAEs) ranging from 3.2 to 5.3 h. Dose fractionation response curves were steep, and the free-drug area under the concentration-time curve over 24 h (AUC0-24)/MIC ratio was the PD index most closely linked to efficacy (R2 = 0.96). The mean free-drug AUC0-24/MIC ratios required to achieve net bacterial stasis, a 1-log10 kill, and a 2-log10 kill for each isolate were 52.6, 89.9, and 164.9, respectively. When integrated with human PK data, these PD targets could provide a framework for further optimization of dosing regimens. This could make antofloxacin an attractive option for the treatment of respiratory tract infections involving K. pneumoniae.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Anti-Bacterial Agents/therapeutic use , Klebsiella Infections/drug therapy , Klebsiella pneumoniae/drug effects , Ofloxacin/analogs & derivatives , Respiratory Tract Infections/drug therapy , Animals , Female , Humans , Klebsiella pneumoniae/isolation & purification , Lung/microbiology , Mice , Mice, Inbred ICR , Microbial Sensitivity Tests , Neutropenia/drug therapy , Neutropenia/microbiology , Ofloxacin/pharmacokinetics , Ofloxacin/therapeutic use , Respiratory Tract Infections/microbiology
8.
Biomed Chromatogr ; 31(9)2017 Sep.
Article in English | MEDLINE | ID: mdl-28205258

ABSTRACT

This study presents a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the simultaneous determination of antofloxacinin and its main metabolite - N-demethylated metabolite (N-DM) - in human urine. Ornidazole was used as the internal standard. This was a clinical urine recovery study, in which 10 healthy Chinese volunteers were intravenously administered a single 200 mg dose of antofloxacin hydrochloride. Compounds were extracted by albumen precipitation, after which samples were isocratically eluted using a Poroshell 120 SB-C18 column, and were analysed using HPLC-MS/MS under electronic spray ionization positive ion mode. The method was successfully applied in a urine pharmacokinetic study of antofloxacinin, with a detection range of 0.02/0.01 to 200/100 µg/mL (for antofioxacin/N-DM).The average percentages of antofioxacin/N-DM measured in urinary excretion frp, 10 volunteers were 54.9 ± 5.7/8.2 ± 2.5% in 120 h duration.


Subject(s)
Chromatography, High Pressure Liquid/methods , Ofloxacin/analogs & derivatives , Tandem Mass Spectrometry/methods , Adolescent , Adult , Drug Stability , Female , Humans , Linear Models , Male , Middle Aged , Ofloxacin/chemistry , Ofloxacin/pharmacokinetics , Ofloxacin/urine , Reproducibility of Results , Sensitivity and Specificity , Young Adult
9.
Biomed Chromatogr ; 30(3): 426-31, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26179954

ABSTRACT

(S)-(-)-Ofloxacin and (R)-(+)-ofloxacin concentrations in the plasma of Pagrosomus major after drug treatment were detected by chiral high-performance liquid chromatography, and various pharmacokinetic parameters were calculated from these data. The elimination half-life of (S)-(-)-ofloxacin was significantly shorter than that of the (R)-(+) enantiomer. (S)-(-)-Ofloxacin also had a significantly lower maximum plasma concentration, area under the concentration-time curve from zero to infinity, and mean residence time than (R)-(+)-ofloxacin. However, the apparent volume of distribution and total body clearance of (S)-(-)-ofloxacin were greater than those of (R)-(+)-ofloxacin. The ratio of the (S)-(-)- to (R)-(+)-ofloxacin plasma concentration was always <1.0. Together, these data suggest that (S)-(-)-ofloxacin was preferentially excreted and (R)-(+)-ofloxacin was preferentially absorbed. Although the difference in pharmacokinetic parameters was small, the metabolic behavior of the ofloxacin enantiomers in P. major was enantioselective.


Subject(s)
Chromatography, High Pressure Liquid/methods , Ofloxacin/blood , Ofloxacin/pharmacokinetics , Sea Bream , Animals , Limit of Detection , Linear Models , Ofloxacin/chemistry , Reproducibility of Results , Stereoisomerism
10.
Antimicrob Agents Chemother ; 59(10): 6073-9, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26195507

ABSTRACT

Ofloxacin is widely used for the treatment of multidrug-resistant tuberculosis (MDR-TB). Data on its pharmacokinetics and safety in children are limited. It is not known whether the current internationally recommended pediatric dosage of 15 to 20 mg/kg of body weight achieves exposures reached in adults with tuberculosis after a standard 800-mg dose (adult median area under the concentration-time curve from 0 to 24 h [AUC0-24], 103 µg · h/ml). We assessed the pharmacokinetics and safety of ofloxacin in children <15 years old routinely receiving ofloxacin for MDR-TB treatment or preventive therapy. Plasma samples were collected predose and at 1, 2, 4, 8, and either 6 or 11 h after a 20-mg/kg dose. Pharmacokinetic parameters were calculated using noncompartmental analysis. Children with MDR-TB disease underwent long-term safety monitoring. Of 85 children (median age, 3.4 years), 11 (13%) were HIV infected, and of 79 children with evaluable data, 14 (18%) were underweight. The ofloxacin mean (range) maximum concentration (Cmax), AUC0-8, and half-life were 8.97 µg/ml (2.47 to 14.4), 44.2 µg · h/ml (12.1 to 75.8), and 3.49 h (1.89 to 6.95), respectively. The mean AUC0-24, estimated in 72 participants, was 66.7 µg · h/ml (range, 18.8 to 120.7). In multivariable analysis, AUC0-24 was increased by 1.46 µg · h/ml for each 1-kg increase in body weight (95% confidence interval [CI], 0.44 to 2.47; P = 0.006); no other assessed variable contributed to the model. No grade 3 or 4 events at least possibly attributed to ofloxacin were observed. Ofloxacin was safe and well tolerated in children with MDR-TB, but exposures were well below reported adult values, suggesting that dosage modification may be required to optimize MDR-TB treatment regimens in children.


Subject(s)
Antitubercular Agents/adverse effects , Antitubercular Agents/pharmacokinetics , Ofloxacin/adverse effects , Ofloxacin/pharmacokinetics , Tuberculosis, Multidrug-Resistant/blood , Tuberculosis, Multidrug-Resistant/drug therapy , Adolescent , Antitubercular Agents/therapeutic use , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Ofloxacin/therapeutic use , Prospective Studies
11.
Antimicrob Agents Chemother ; 58(1): 503-10, 2014.
Article in English | MEDLINE | ID: mdl-24189253

ABSTRACT

Pharmacokinetic exposure and the MIC of fluoroquinolones are important determinants of their efficacy against Mycobacterium tuberculosis. Population modeling was used to describe the steady-state plasma pharmacokinetics of moxifloxacin in 241 tuberculosis (TB) patients in southern Africa. Monte Carlo simulations were applied to obtain the area under the unbound concentration-time curve from 0 to 24 h (fAUC0-24) after daily doses of 400 mg or 800 mg moxifloxacin and 800 mg ofloxacin. The MIC distributions of ofloxacin and moxifloxacin were determined for 197 drug-resistant clinical isolates of Mycobacterium tuberculosis. For a specific MIC, the probability of target attainment (PTA) was determined for target fAUC0-24/MIC ratios of ≥53 and ≥100. The PTAs were combined with the MIC distributions to calculate the cumulative fraction of response (CFR) for multidrug-resistant (MDR) Mycobacterium tuberculosis strains. Even with the less stringent target ratio of ≥53, moxifloxacin at 400 mg and ofloxacin at 800 mg achieved CFRs of only 84% and 58% for multidrug-resistant isolates with resistance to an injectable drug, while the 800-mg moxifloxacin dose achieved a CFR of 98%. Using a target ratio of ≥100 for multidrug-resistant strains (without resistance to injectable agents or fluoroquinolones), the CFR was 88% for moxifloxacin and only 43% for ofloxacin, and the higher dose of 800 mg moxifloxacin was needed to achieve a CFR target of >90%. Our results indicate that moxifloxacin is more efficacious than ofloxacin in the treatment of MDR-TB. Further studies should determine the optimal pharmacodynamic target for moxifloxacin in a multidrug regimen and clarify safety issues when it is administered at higher doses.


Subject(s)
Antitubercular Agents/pharmacokinetics , Fluoroquinolones/pharmacokinetics , Ofloxacin/pharmacokinetics , Adult , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Monte Carlo Method , Moxifloxacin , Tuberculosis, Multidrug-Resistant , Young Adult
12.
Antimicrob Agents Chemother ; 58(5): 2948-51, 2014 May.
Article in English | MEDLINE | ID: mdl-24550337

ABSTRACT

Limited data on fluoroquinolone pharmacokinetics and cardiac effects in children exist. Among 22 children receiving drug-resistant tuberculosis prophylaxis or treatment, serum concentrations following oral doses of levofloxacin (15 mg/kg of body weight) and ofloxacin (20 mg/kg) were lower than those expected from existing pediatric data, possibly due to differences in the formulations (crushed tablets). Drug exposures were lower than those in adults following standard doses and below the proposed pharmacodynamic targets, likely due to more rapid elimination in children. No QT prolongation was observed.


Subject(s)
Antitubercular Agents/pharmacokinetics , Antitubercular Agents/therapeutic use , Levofloxacin/pharmacokinetics , Levofloxacin/therapeutic use , Ofloxacin/pharmacokinetics , Ofloxacin/therapeutic use , Tuberculosis, Multidrug-Resistant/drug therapy , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Prospective Studies , Tuberculosis, Multidrug-Resistant/blood
13.
Antimicrob Agents Chemother ; 58(2): 782-8, 2014.
Article in English | MEDLINE | ID: mdl-24247125

ABSTRACT

Little is known about plasma drug concentrations relative to quantitative susceptibility in patients with multidrug-resistant tuberculosis (MDR-TB). We previously described a TB drug activity (TDA) assay that determines the ratio of the time to detection of plasma-cocultured Mycobacterium tuberculosis versus control growth in a Bactec MGIT system. Here, we assess the activity of individual drugs in a typical MDR-TB regimen using the TDA assay. We also examined the relationship of the TDA to the drug concentration at 2 h (C2) and the MICs among adults on a MDR-TB regimen in Tanzania. These parameters were also compared to the treatment outcome of sputum culture conversion. Individually, moxifloxacin yielded superior TDA results versus ofloxacin, and only moxifloxacin and amikacin yielded TDAs equivalent to a -2-log killing. In the 25 patients enrolled on a regimen of kanamycin, levofloxacin, ethionamide, pyrazinamide, and cycloserine, the C2 values were found to be below the expected range for levofloxacin in 13 (52%) and kanamycin in 10 (40%). Three subjects with the lowest TDA result (<1.5, a finding indicative of poor killing) had significantly lower kanamycin C2/MIC ratios than subjects with a TDA of ≥1.5 (9.8 ± 8.7 versus 27.0 ± 19.1; P = 0.04). The mean TDAs were 2.52 ± 0.76 in subjects converting to negative in ≤2 months and 1.88 ± 0.57 in subjects converting to negative in >2 months (P = 0.08). In Tanzania, MDR-TB drug concentrations were frequently low, and a wide concentration/MIC range was observed that affected plasma drug activity ex vivo. An opportunity exists for pharmacokinetic optimization in current MDR-TB regimens, which may improve treatment response.


Subject(s)
Antitubercular Agents/blood , Mycobacterium tuberculosis/drug effects , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Pulmonary/drug therapy , Adolescent , Adult , Amikacin/blood , Amikacin/pharmacokinetics , Amikacin/therapeutic use , Antitubercular Agents/pharmacokinetics , Antitubercular Agents/therapeutic use , Cycloserine/blood , Cycloserine/pharmacokinetics , Cycloserine/therapeutic use , Ethionamide/blood , Ethionamide/pharmacokinetics , Ethionamide/therapeutic use , Female , Fluoroquinolones/blood , Fluoroquinolones/pharmacokinetics , Fluoroquinolones/therapeutic use , Humans , Kanamycin/blood , Kanamycin/pharmacokinetics , Kanamycin/therapeutic use , Levofloxacin/blood , Levofloxacin/pharmacokinetics , Levofloxacin/therapeutic use , Male , Microbial Sensitivity Tests , Middle Aged , Moxifloxacin , Mycobacterium tuberculosis/growth & development , Ofloxacin/blood , Ofloxacin/pharmacokinetics , Ofloxacin/therapeutic use , Pyrazinamide/blood , Pyrazinamide/pharmacokinetics , Pyrazinamide/therapeutic use , Sputum/microbiology , Tanzania , Tuberculosis, Multidrug-Resistant/blood , Tuberculosis, Multidrug-Resistant/microbiology , Tuberculosis, Pulmonary/blood , Tuberculosis, Pulmonary/microbiology
14.
Xenobiotica ; 44(10): 893-901, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24650193

ABSTRACT

1. The pharmacokinetics of acetaminophen (marker of gastric emptying), antipyrine (marker of hepatic metabolic activity and total body water), diazepam (lipophilic and highly distributed), diphenhydramine (hepatic blood flow-limited and alpha-1 acid glycoprotein bound) and ofloxacin (renally eliminated) were evaluated in cynomolgus monkeys (3-18 years old) and beagle dogs (2-11 years old) as models in elderly persons. 2. Gastric pH fluctuated with aging in monkeys and dogs. The concentration of alpha-1 acid glycoprotein appeared to be increased by aging. There were no age-related differences in the absorption rates of the drugs under the conditions used in the study. Total body fat increased and water decreased in monkeys, but these parameters did not change in dogs. 3. Hepatic blood flow decreased in both species, but a significant decrease of hepatic clearance was only seen in monkeys. Renal clearance decreased significantly with age in monkeys and showed a tendency to decrease in dogs. 4. Age-related alterations of physiological parameters in monkeys are in agreement with clinical observations in humans, except for the lack of a change in the plasma albumin concentration. Therefore, this study suggests that monkey might be a suitable animal model for prediction of age-related changes in pharmacokinetics in humans.


Subject(s)
Acetaminophen/pharmacokinetics , Aging/metabolism , Antipyrine/pharmacokinetics , Diazepam/pharmacokinetics , Diphenhydramine/pharmacokinetics , Ofloxacin/pharmacokinetics , Age Factors , Albumins/metabolism , Animals , Blood Proteins/metabolism , Dogs , Gastric Juice/chemistry , Hydrogen-Ion Concentration , Macaca fascicularis , Male , Models, Animal
15.
Am J Respir Crit Care Med ; 188(1): 97-102, 2013 Jul 01.
Article in English | MEDLINE | ID: mdl-23593945

ABSTRACT

RATIONALE: High-dose levofloxacin (L) (1,000 mg) was as active as moxifloxacin (M) (400 mg) in an early bactericidal activity trial, suggesting these fluoroquinolones could be used interchangeably. Whether pyrazinamide (Z) contributes sterilizing activity beyond the first 2 months in fluoroquinolone-containing second-line regimens remains unknown. OBJECTIVES: We compared the efficacy of M and high-dose L alone or in combination with ethionamide (Et), amikacin (A), and Z given for 2 or 7 months. METHODS: A pharmacokinetic study was performed to determine the L dose equivalent to 1,000 mg in humans. Treatment started 2 weeks after aerosol infection with Mycobacterium tuberculosis H37Rv. Mice received M or L alone or in combination with 2 months of EtZA followed by 5 months of Et or EtZ. MEASUREMENTS AND MAIN RESULTS: After 2 months of treatment, lung colony-forming unit (CFU) counts were similar in mice receiving either fluoroquinolone alone, but, after 4 and 5 months, CFU counts were 2 log10 lower in mice receiving M. Mice receiving 2MEtZA/3MEt and 2LEtZA/3LEt had 1.0 and 2.7 log10 lung CFUs, respectively. When Z was given throughout, both regimens rendered mice culture negative by 5 months, and most mice did not relapse after 7 months of treatment, with fewer relapses observed in the M group after 6 and 7 months of treatment. CONCLUSIONS: In murine tuberculosis, M had superior efficacy compared with L despite lower serum drug exposures and may remain the fluoroquinolone of choice for second-line regimens. Z contributed substantial sterilizing activity beyond 2 months in fluoroquinolone-containing second-line regimens, largely compensating for L's weaker activity.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Antitubercular Agents/administration & dosage , Aza Compounds/administration & dosage , Levofloxacin , Ofloxacin/therapeutic use , Pyrazinamide/administration & dosage , Quinolines/administration & dosage , Tuberculosis/drug therapy , Analysis of Variance , Animals , Anti-Bacterial Agents/pharmacokinetics , Antitubercular Agents/pharmacokinetics , Aza Compounds/pharmacokinetics , Disease Models, Animal , Drug Administration Schedule , Drug Therapy, Combination/methods , Female , Fluoroquinolones , Mice , Mice, Inbred BALB C , Moxifloxacin , Ofloxacin/pharmacokinetics , Pyrazinamide/pharmacokinetics , Quinolines/pharmacokinetics , Treatment Outcome
16.
Biom J ; 56(5): 886-900, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24827551

ABSTRACT

Many scientific processes, specially in pharmacokinetics (PK) and pharmacodynamics (PD) studies, are defined by a system of ordinary differential equations (ODE). If there are unknown parameters that need to be estimated, the optimal experimental design approach offers quality estimators for the different objectives of the practitioners. When computing optimal designs the standard procedure uses the linearization of the analytical expression of the ODE solution, which is not feasible when this analytical form does not exist. In this work some methods to solve this problem are described and discussed. Optimal designs for two well-known example models, Iodine and Michaelis-Menten, have been computed using the proposed methods. A thorough study has been done for a specific two-parameter PK model, the biokinetic model of ciprofloxacin and ofloxacin, computing the best designs for different optimality criteria and numbers of points. The designs have been compared according to their efficiency, and the goodness of the designs for the estimation of each parameter has been checked. Although the objectives of the paper are focused on the optimal design field, the methodology can be used as well for a sensitivity analysis of ordinary differential equation systems.


Subject(s)
Computer Simulation , Models, Chemical , Research Design/standards , Ciprofloxacin/pharmacokinetics , Models, Statistical , Ofloxacin/pharmacokinetics
17.
Vestn Ross Akad Med Nauk ; (1-2): 80-4, 2014.
Article in Russian | MEDLINE | ID: mdl-25055566

ABSTRACT

AIM: To study features of pharmacokinetics of ofloxacin as a part of anion PEGylated niosomes on a basis of sorbitan monostearate (Span 60) to experimental white mice per os. MATERIALS AND METHODS: Ofloxacin was entrapped in niosomes consisting of Span 60, cholesterol, PEG 4000 and dicetylphosphate. Sizes of niosomes estimated by means of probe microscopy. Efficiency of inclusion of an antibiotic in niosomes defined after removal of free drug by a centrifugation. The analysis of the quantitative contents of ofloxacin in samples carried out a method of a high performance liquid chromatography. RESULTS: We studied the main pharmacokinetic parameters of ofloxacin when used free and niosomal forms of antibiotic to experimental white mice per os. It is shown that use of oral niosomal forms leads to decrease of maximal concentration in serum and increase of ofloxacin half-life by 7,4 times in average compared to the free form. It is determined that bioavailability of ofloxacin in the niosomal form is 154% relative to the free form of the antibiotic. CONCLUSIONS: Niosomal microcontainers are perspective technology of encapsulation and the directe transport of antibacterial preparations through biological barriers. Using of niosomal formulation of ofloxacin is able to afford to increase considerably efficiency of treatment in comparison with a free form and significantly decrease negative effects of antibiotic therapy.


Subject(s)
Drug Carriers/pharmacokinetics , Liposomes/administration & dosage , Ofloxacin/pharmacokinetics , Administration, Oral , Animals , Biological Availability , Cholesterol/chemistry , Drug Carriers/administration & dosage , Half-Life , Hexoses/chemistry , Liposomes/chemistry , Mice , Ofloxacin/administration & dosage , Ofloxacin/blood , Polyethylene Glycols/chemistry
18.
J Antimicrob Chemother ; 68(5): 1130-8, 2013 May.
Article in English | MEDLINE | ID: mdl-23361641

ABSTRACT

OBJECTIVES: We aim to further define the impact of the mechanism of fluoroquinolone resistance and inoculum load on the pharmacodynamic effects of levofloxacin and moxifloxacin on Streptococcus pneumoniae. METHODS: The antibacterial effects of and emergence of resistance (EoR) to moxifloxacin (400 mg once daily) or levofloxacin (750 mg once daily or 500 mg twice daily) were compared using five S. pneumoniae strains containing no known resistance mechanisms, efflux resistance mechanisms, a parC mutation or parC and gyrA mutations, at high (10(8) cfu/mL) and low (10(6) cfu/mL) inocula. An in vitro pharmacokinetic model was used and simulations were performed over 96 h. After drug exposure, isolates were tested for the presence of efflux pumps and mutations in the quinolone resistance-determining regions. RESULTS: A high inoculum diminished the antibacterial effect of moxifloxacin and levofloxacin. Levofloxacin at both dosages produced EoR with all strains. Levofloxacin regimens with AUC/MIC ratios <100 produced EoR. Moxifloxacin produced EoR with the parC strain only. CONCLUSIONS: Levofloxacin dosing regimens with low AUC/MIC ratios select for efflux pump overexpression, leading to fluoroquinolone resistance. Levofloxacin dosing may select for gyrA mutations, inducing moxifloxacin resistance. These data confirm that a fluoroquinolone AUC/MIC ratio of >100 is required for prevention of EoR.


Subject(s)
Anti-Bacterial Agents/pharmacology , Aza Compounds/pharmacology , Drug Resistance, Bacterial , Levofloxacin , Ofloxacin/pharmacology , Quinolines/pharmacology , Streptococcus pneumoniae/drug effects , Anti-Bacterial Agents/pharmacokinetics , Aza Compounds/pharmacokinetics , Bacterial Load , Fluoroquinolones , Models, Theoretical , Moxifloxacin , Mutation , Ofloxacin/pharmacokinetics , Quinolines/pharmacokinetics , Selection, Genetic
19.
J Labelled Comp Radiopharm ; 56(12): 627-31, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24285239

ABSTRACT

Even in recent decades, one of the major causes of death and unhealthiness in the whole world is infection and inflammation. The use of radiopharmaceuticals is a powerful tool in managing the patients with infectious diseases. In this study, ofloxacin as a second-generation fluoroquinolone has been labeled with [(99m) Tc(CO)3 (H2 O)3 ](+) core to formulate a suitable infection imaging agent. Ofloxacin was radiolabeled with (99m) Tc using carbonyl core. Radioligand chemical analysis involved HPLC methods. Radioconjugate stability and lipophilicity were determined. Binding with Staphylococcus aureus and biodistribution in infected mice for labeled compound were studied. The radioligand was characterized by HPLC, and its radiochemical purity was more than 90%. In vitro stability studies have shown the complex was stable at least 6 h after labeling at room temperature. The n-octanol/water partition coefficient experiment exhibited logP = 1.52 ± 0.21 for (99m) Tc(CO)3 -ofloxacin. The complex showed specific binding to S. aureus. Biodistribution results showed that radioligand had high accumulation in the infected muscle in a mice (T/NT = 2.02 ± 0.12 at 4 h postinjection). On the basis of stability and infection site uptake ratio, suitability of this complex as a radiotracer for imaging of infections is recognized.


Subject(s)
Anti-Bacterial Agents/chemical synthesis , Ofloxacin/chemical synthesis , Staphylococcal Infections/diagnostic imaging , Technetium/chemistry , Animals , Anti-Bacterial Agents/pharmacokinetics , Anti-Bacterial Agents/pharmacology , Isotope Labeling , Male , Mice , Mice, Inbred BALB C , Muscle, Skeletal/microbiology , Ofloxacin/pharmacokinetics , Ofloxacin/pharmacology , Radionuclide Imaging , Staphylococcus aureus/drug effects , Technetium/pharmacokinetics , Technetium/pharmacology
20.
Pak J Pharm Sci ; 26(6): 1089-96, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24191311

ABSTRACT

Niosomes are non ionic surfactant vesicles and potential surrogate for liposomes. The aim of the present investigation was to formulate and evaluate niosomes. The formulated ofloxacin niosomes were evaluated for their particle size, zeta potential, surface morphology, entrapment efficiency, in vitro drug release and in vivo pharmacokinetic studies. Niosomes of ofloxacin were prepared by thin film hydration technique using rotary flash evaporator. The formulated ofloxacin niosomes showed a vesicle size of 3.0-3.8 µm and zeta potential of -9 to -13 mV. The in vitro release studies showed 98.79% of ofloxacin release in sustained manner following first order kinetics. The stability study confirmed the stability of Ofloxacin niosomes. Pharmacokinetics studies of ofloxacin niosomes made with Span 60 showed increased Cmax AUC, AUMC, t1/2 and MRT values compared to marketed intravenous ofloxacin product. The designed ofloxacin niosomes with span 60 showed good physicochemical properties, good stability, improved pharmacokinetic parameters, prolonged action and improved bioavailability than the commercially available conventional dosage form which might be a potential carrier system to improve the patient compliance and reduce the side effects.


Subject(s)
Ofloxacin/administration & dosage , Animals , Biological Availability , Drug Stability , Liposomes/chemistry , Male , Ofloxacin/chemistry , Ofloxacin/pharmacokinetics , Rabbits , Solubility
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