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1.
Pediatr Infect Dis J ; 40(5): 434-439, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33181784

RESUMEN

BACKGROUND: Adequate dosage recommendations are imperative for successful treatment of invasive infections. We evaluated the occurrence of sub- and supratherapeutic serum and cerebrospinal fluid (CSF) concentrations of benzylpenicillin (BPEN) in neonates treated for a severe group B streptococci (GBS) sepsis and/or meningitis as well as discrepancies in dosing recommendations provided by pediatric reference sources. METHODS: Retrospective analysis of (pre)term infants treated with BPEN undergoing therapeutic drug monitoring (TDM) between May 2015 and May 2019. Outcomes included numbers of sub- and supratherapeutic concentrations, and dose adjustments, clinical evolution, and dosing recommendations from six pediatric reference sources. RESULTS: A total of 21 TDM samples from 8 neonates were evaluated. Among serum concentrations, 9/21 (43%) were below and 8/21 (38%) above the pre-specified therapeutic target range of 10-20 mg/L. Only 1 patient had BPEN determined in CSF whose concentration was below the lower limit of quantification. TDM identified a need for dose modification in 10/21 (48%) instances. Three of eight patients exhibited complete resolution of clinical, laboratory and radiologic signs of infection. Substantial variation in dosing recommendations (50,000-400,000 IE/kg/d) was present between reference sources. CONCLUSIONS: Our data reveal that under current dosage recommendations, the predefined target serum or CSF concentrations of BPEN are not achieved in all children. In case of clinical failure, serum and/or CSF BPEN concentrations should be determined. Given the wide variation in concentrations and subsequent dose requirements, further exploration of the clinical and pharmacologic characteristics of BPEN in (pre)term neonates is essential to optimize therapeutic efficacy.


Asunto(s)
Antibacterianos/administración & dosificación , Meningitis/tratamiento farmacológico , Sepsis Neonatal/tratamiento farmacológico , Penicilina G/administración & dosificación , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus agalactiae , Antibacterianos/sangre , Antibacterianos/líquido cefalorraquídeo , Estudios de Cohortes , Monitoreo de Drogas , Femenino , Humanos , Recién Nacido , Masculino , Países Bajos/epidemiología , Penicilina G/sangre , Penicilina G/líquido cefalorraquídeo , Estudios Retrospectivos , Centros de Atención Terciaria
2.
Food Chem ; 288: 39-46, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-30902309

RESUMEN

In-situ growth of zeolite imidazolate frameworks (ZIFs) on the surface of layered double hydroxides (LDHs) for preparation of porous nanocomposites is a favorable strategy to design potential materials in separation fields. In this research, nanoporous Zn-Al LDH/ZIF-8 composite was prepared by in-situ growth of ZIF-8 on the Zn-Al LDH surface. The nanocomposite was applied for stir bar sorptive extraction and detection of benzylpenicillin (penicillin G, PEN G). Characterizations of the nanocomposite were performed by various techniques, including Fourier transform infrared spectroscopy, X-ray diffraction, field emission scanning electron microscopy, energy dispersive X-ray spectroscopy and thermogravimetric differential thermal analysis. An optimized strategy based on response surface methodology was combined with high performance liquid chromatography analysis. Under the optimized conditions, the limit of detection and quantification obtained were 0.05 and 0.15 µg l-1, respectively. The good validation criteria results allowed the method to be used in the quantification of PEN G in real samples.


Asunto(s)
Aluminio/química , Cromatografía Líquida de Alta Presión/métodos , Hidróxidos/química , Nanocompuestos/química , Nanopartículas/química , Penicilina G/análisis , Zeolitas/química , Adsorción , Animales , Análisis de los Alimentos , Humanos , Límite de Detección , Estructuras Metalorgánicas/química , Leche/química , Leche/metabolismo , Penicilina G/sangre , Penicilina G/orina
3.
J Vet Pharmacol Ther ; 41(5): 691-698, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29889313

RESUMEN

The aim of this study was to determine the intramammary dose of benzylpenicillin required to maintain a concentration in the milk above the MIC for the Gram-positive bacteria that cause mastitis. The product used in this study was a commercially available procaine benzylpenicillin in an oily suspension with micronized particles. Three dose levels were used: 200,000, 300,000, and 600,000 IU. Concentrations of benzylpenicillin in cow milk and plasma were determined after a single intramammary dose was administered into one quarter of each of the five cows in each treatment group. Samples were analyzed using an HPLC-MS/MS method, which was validated during the study. Concentrations in the milk were well above the MIC for the target pathogens for all doses tested. There was a linear dose-dependent increase in the mean AUCs of benzylpenicillin concentrations in plasma and milk. At the first milking, 12 hr after dosing, there was a significant difference between the mean milk benzylpenicillin concentrations in cows treated with a dose of 600,000 IU, and those treated with 200,000 or 300,000 IU. Although this study shows a linear relationship between the dose of procaine benzylpenicillin administered and the concentration in the milk in the healthy udder, it would be useful to conduct studies on cows with mastitis to define the optimum dose and duration of intramammary treatment with benzylpenicillin.


Asunto(s)
Antibacterianos/administración & dosificación , Glándulas Mamarias Animales/microbiología , Leche/química , Penicilina G/administración & dosificación , Animales , Antibacterianos/análisis , Antibacterianos/sangre , Bovinos , Relación Dosis-Respuesta a Droga , Femenino , Bacterias Grampositivas/efectos de los fármacos , Inyecciones/veterinaria , Glándulas Mamarias Animales/metabolismo , Penicilina G/análisis , Penicilina G/sangre
4.
Drug Deliv Transl Res ; 8(2): 317-328, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-28512690

RESUMEN

Bovine mastitis caused by bacterial infections of the mammary gland (udder) of dairy cows is a costly pathology for the dairy industry due to direct and indirect losses in production. Penethamate, a pro-drug of benzylpenicillin, is used by intramuscular injection (IM). The existing products are powders which must be reconstituted in water-for-injection and this presents difficulties in the field. Penethamate is too unstable to be formulated as an aqueous formulation but a chemically stable suspension formulation was possible in certain oils; however, some literature suggests that such formulations would have unacceptable prolonged release. The translational research proceeded iteratively from lab to the target species, rather than via laboratory animal trials. Pilot studies in cows suggested that some oily suspensions would give concentrations of benzylpenicillin, (in both blood and milk) comparable with those of the reconstituted product. A physicochemical screen and a low level in vitro-in vivo correlation (IVIVC) was cautiously used to guide selection of formulations for subsequent animal trials which have resulted in a lead formulation for good laboratory practices (GLP), good clinical practices (GCP) studies.


Asunto(s)
Antibacterianos/administración & dosificación , Antibacterianos/farmacocinética , Leche/metabolismo , Penicilina G/análogos & derivados , Animales , Antibacterianos/sangre , Antibacterianos/química , Bovinos , Liberación de Fármacos , Femenino , Inyecciones Intramusculares , Mastitis Bovina/tratamiento farmacológico , Mastitis Bovina/metabolismo , Penicilina G/administración & dosificación , Penicilina G/sangre , Penicilina G/química , Penicilina G/farmacocinética , Investigación Biomédica Traslacional
5.
Artículo en Inglés | MEDLINE | ID: mdl-29084754

RESUMEN

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.


Asunto(s)
Amoxicilina/sangre , Ampicilina/sangre , Antibacterianos/sangre , Floxacilina/sangre , Penicilina G/sangre , Piperacilina/sangre , Cromatografía Líquida de Alta Presión , Estabilidad de Medicamentos , Humanos , Espectrometría de Masas en Tándem
6.
Artículo en Inglés | MEDLINE | ID: mdl-28559267

RESUMEN

Rheumatic heart disease (RHD) remains an important global health challenge. Administration of benzathine penicillin (BPG) every 3 to 4 weeks is recommended as a secondary prophylaxis to prevent recurrent episodes of acute rheumatic fever and subsequent RHD. Following intramuscular injection, BPG is hydrolyzed to penicillin G (benzylpenicillin). However, little is known of the pharmacokinetics (PK) of BPG in pediatric populations at high risk of RHD or of the pharmacokinetic-pharmacodynamic relationship between penicillin exposure and clinically relevant outcomes. Dried blood spot (DBS) assays can facilitate PK studies in situations where frequent venous blood sampling is logistically difficult. A liquid chromatography-mass spectroscopy assay for penicillin G in plasma and DBS was developed and validated. Application of the DBS assay for PK studies was confirmed using samples from adult patients receiving penicillin as part of an infection management plan. The limit of quantification for penicillin G in DBS was 0.005 mg/liter. Penicillin G is stable in DBS for approximately 12 h at room temperature (22°C), 6 days at 4°C, and >1 month at -20°C. Plasma and DBS penicillin G concentrations for patients receiving BPG and penicillin G given via bolus doses correlated well and had comparable time-concentration profiles. There was poor correlation for patients receiving penicillin via continuous infusions, perhaps as a result of the presence of residual penicillin in the peripherally inserted central catheter, from which the plasma samples were collected. The present DBS penicillin G assay can be used as a surrogate for plasma concentrations to provide valid PK data for studies of BPG and other penicillin preparations developed to prevent rheumatic fever and RHD.


Asunto(s)
Antibacterianos/sangre , Pruebas con Sangre Seca/métodos , Penicilina G Benzatina/sangre , Penicilina G/sangre , Fiebre Reumática/prevención & control , Adulto , Anciano , Antibacterianos/administración & dosificación , Femenino , Humanos , Inyecciones Intramusculares , Límite de Detección , Masculino , Persona de Mediana Edad , Penicilina G/administración & dosificación , Penicilina G Benzatina/administración & dosificación , Cardiopatía Reumática/prevención & control
7.
Basic Clin Pharmacol Toxicol ; 120(2): 179-186, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27565458

RESUMEN

Penicillin G is frequently used to treat infective endocarditis (IE) caused by streptococci, penicillin-susceptible staphylococci and enterococci. Appropriate antibiotic exposure is essential for survival and reduces the risk of complications and drug resistance development. We determined penicillin G plasma concentration [p-penicillin] once weekly in 46 IE patients. The aim was to evaluate whether penicillin G 3 g every 6 hr (q6 h) resulted in therapeutic concentrations and to analyse potential factors that influence inter- and intra-individual variability, using linear regression and a random coefficient model. [P-penicillin] at 3 hr and at 6 hr was compared with the minimal inhibitory concentration (MIC) of the bacteria isolated from blood cultures to evaluate the following PK/PD targets: 50% fT > MIC and 100% fT > MIC. [P-penicillin] varied notably between patients and was associated with age, weight, p-creatinine and estimated creatinine clearance (eCLcr). Additionally, an increase in [p-penicillin] during the treatment period showed strong correlation with age, a low eCLcr, a low weight and a low p-albumin. Of the 46 patients, 96% had [p-penicillin] that resulted in 50% fT > MIC, while 71% had [p-penicillin] resulting in 100% fT > MIC. The majority of patients not achieving the 100% fT > MIC target were infected with enterococci. Streptococci and staphylococci isolated from blood cultures were highly susceptible to penicillin G. Our results suggest that penicillin G 3 g q6 h is suitable to treat IE caused by streptococci and penicillin-susceptible staphylococci, but caution must be taken when the infection is caused by enterococci. When treating enterococci, therapeutic drug monitoring should be applied to optimize penicillin G dosing and exposure.


Asunto(s)
Antibacterianos/administración & dosificación , Antibacterianos/sangre , Endocarditis Bacteriana/tratamiento farmacológico , Penicilina G/administración & dosificación , Penicilina G/sangre , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/tratamiento farmacológico , Anciano , Antibacterianos/farmacocinética , Esquema de Medicación , Cálculo de Dosificación de Drogas , Monitoreo de Drogas/métodos , Endocarditis Bacteriana/sangre , Endocarditis Bacteriana/microbiología , Femenino , Humanos , Modelos Lineales , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Penicilina G/farmacocinética , Estudios Prospectivos , Recurrencia , Infecciones Estafilocócicas/sangre , Infecciones Estafilocócicas/microbiología , Infecciones Estreptocócicas/sangre , Infecciones Estreptocócicas/microbiología , Resultado del Tratamiento
9.
Antimicrob Agents Chemother ; 58(8): 4495-503, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24867969

RESUMEN

Extralabel drug use of penicillin G in food-producing animals may cause an excess of residues in tissue which will have the potential to damage human health. Of all the antibiotics, penicillin G may have the greatest potential for producing allergic responses to the consumer of food animal products. There are, however, no population pharmacokinetic studies of penicillin G for food animals. The objective of this study was to develop a population pharmacokinetic model to describe the time-concentration data profile of penicillin G across two species. Data were collected from previously published pharmacokinetic studies in which several formulations of penicillin G were administered to diverse populations of cattle and swine. Liver, kidney, and muscle residue data were also used in this study. Compartmental models with first-order absorption and elimination were fit to plasma and tissue concentrations using a nonlinear mixed-effect modeling approach. A 3-compartment model with extra tissue compartments was selected to describe the pharmacokinetics of penicillin G. Typical population parameter estimates (interindividual variability) were central volumes of distribution of 3.45 liters (12%) and 3.05 liters (8.8%) and central clearance of 105 liters/h (32%) and 16.9 liters/h (14%) for cattle and swine, respectively, with peripheral clearance of 24.8 liters/h (13%) and 9.65 liters/h (23%) for cattle and 13.7 liters/h (85%) and 0.52 liters/h (40%) for swine. Body weight and age were the covariates in the final pharmacokinetic models. This study established a robust model of penicillin for a large and diverse population of food-producing animals which could be applied to other antibiotics and species in future analyses.


Asunto(s)
Antibacterianos/farmacocinética , Carne/análisis , Modelos Estadísticos , Penicilina G/farmacocinética , Factores de Edad , Animales , Antibacterianos/sangre , Peso Corporal , Bovinos , Humanos , Inyecciones Intramusculares , Inyecciones Intravenosas , Riñón/química , Riñón/metabolismo , Hígado/química , Hígado/metabolismo , Músculo Esquelético/química , Músculo Esquelético/metabolismo , Penicilina G/sangre , Especificidad de la Especie , Porcinos
10.
Eur J Pharm Sci ; 59: 94-103, 2014 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-24747579

RESUMEN

Probe substrates for, and inhibitors of, specific transporters are desired to evaluate quantitatively the in vivo functions of transporters in humans. Based on published data, adefovir and benzylpenicillin were selected as organic anion transporter (OAT) 1- and OAT3-selective probe substrates, respectively. In human kidney slices, probenecid potently inhibited the uptake of both adefovir and benzylpenicillin with inhibition constant (Ki) values of 18.6±5.1 and 12.6±4.2µM, respectively, whereas p-aminohippurate (PAH) preferentially inhibited adefovir uptake. A clinical drug-interaction study involving healthy subjects was performed to investigate the dose-dependent inhibition potencies of probenecid and PAH on the renal clearance of the probe substrates. Adefovir or benzylpenicillin was coadministered with different oral doses of probenecid (500, 750, or 1500mg) or intravenous PAH infusion rates (70, 120, or 210mg/min/person) to the same subject using a crossover design. The renal clearance of adefovir was reduced by 45% and 46% in the subjects treated with the maximum dose of probenecid and PAH, respectively, which was in accordance with the results of in vitro inhibition study. On the other hand, renal clearance of benzylpenicillin was reduced by 78% in the subjects treated with the maximum dose of probenecid (1500mg), which could be explained by its in vitro Ki values. However, PAH unexpectedly increased the renal clearance of benzylpenicillin by 47%. These results suggest that adefovir and benzylpenicillin can be used as probe drugs for OAT1 and OAT3, respectively, and that PAH can be used to investigate the role of OAT1 in the urinary excretion of drugs in humans, whereas it may modulate other transport processes in the kidney.


Asunto(s)
Adenina/análogos & derivados , Riñón/efectos de los fármacos , Proteína 1 de Transporte de Anión Orgánico/antagonistas & inhibidores , Transportadores de Anión Orgánico Sodio-Independiente/antagonistas & inhibidores , Organofosfonatos/farmacocinética , Penicilina G/farmacocinética , Probenecid/farmacología , Ácido p-Aminohipúrico/farmacología , Adenina/sangre , Adenina/farmacocinética , Adulto , Interacciones Farmacológicas , Células HEK293 , Humanos , Técnicas In Vitro , Riñón/metabolismo , Masculino , Proteína 1 de Transporte de Anión Orgánico/metabolismo , Transportadores de Anión Orgánico Sodio-Independiente/metabolismo , Organofosfonatos/sangre , Penicilina G/sangre , Adulto Joven
11.
Res Vet Sci ; 95(1): 212-8, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23419937

RESUMEN

The aim was to supply information about the possibility of replacing the procaine salt with the sodium salt for benzylpenicillin IM treatment in horse in order to diminish the risk for procaine adverse effects. In a crossover study eight horses were given 15 mg/kg sodium benzylpenicillin (Na-pc) twice daily or procaine benzylpenicillin (control) once daily IM for four days. The half-life of Na-pc was 1.9h, peak concentration was 14,600 ng/mL reached after about 23 min. Trough plasma concentration was 281 ng/mL and protein binding 62.8%. The fT>MIC for Staphylococcus aureus was 63% and 100% for Streptococcus equi subsp. equi and Streptococcus zooepidemicus, indicating an adequate antimicrobial therapy. However, Na-pc cannot be recommended from a welfare point of view since the horses showed more pain related behaviour and more pain and swelling compared to the control treatment.


Asunto(s)
Caballos/metabolismo , Penicilina G Procaína/farmacocinética , Penicilina G/farmacocinética , Animales , Área Bajo la Curva , Estudios Cruzados , Femenino , Semivida , Inyecciones Intramusculares/veterinaria , Masculino , Pruebas de Sensibilidad Microbiana , Dolor/tratamiento farmacológico , Dolor/metabolismo , Penicilina G/administración & dosificación , Penicilina G/sangre , Penicilina G Procaína/administración & dosificación , Penicilina G Procaína/sangre
12.
Clin Microbiol Infect ; 19(9): 869-74, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23190049

RESUMEN

There is a need for analytical methods capable of monitoring blood antibiotic levels in real time. Here we present a method for quantifying antibiotic levels in whole blood that does not require any sample pretreatment. The tests employ the enzyme penicillinase to assay for penicillin G, penicillin V and ampicillin using a flow-injected biosensor, the Enzyme Thermistor. Optimal flow rates, sample volumes and pH were determined to be 0.5 mL/min, 100 µL and 7.0, respectively. Analysis of the antibiotics diluted in buffer gave a linear range of 0.17-5.0 mM. Calibration curves prepared using blood spiked with the antibiotics gave a linear range of 0.17-2.0 mM. Linear regression values for all of the calibration curves were 0.998 or higher. Assay cycle time was 5 min. The relative standard deviation value for 100 determinations of a mock blood sample spiked with penicillin G was 6.71%. Despite the elimination of sample pretreatment, no detectable clogging or signal drift was observed. The assay provides a fast, simple, reliable analytical method for determining antibiotic concentrations in blood without the need for any sample pretreatment. This is an important first step towards developing a device capable of real-time monitoring of antibiotic levels in whole blood. The technology has the potential to significantly improve the outcomes of patients undergoing critical care.


Asunto(s)
Ampicilina/sangre , Técnicas Biosensibles/métodos , Cromatografía Líquida de Alta Presión/métodos , Penicilina G/sangre , Penicilina V/sangre , Antibacterianos/sangre , Humanos , Penicilinasa
13.
Se Pu ; 30(5): 445-51, 2012 May.
Artículo en Chino | MEDLINE | ID: mdl-22934405

RESUMEN

A fast method for the quantitative determination of penicillin G (PEN G) , penicilloic acid and penilloic acid in blood with ultra performance liquid chromatography-electrospray tandem mass spectrometry was developed. A simple deproteinization of the blood was used with a mixed solution of acetonitrile and water (4:1, v/v) as extraction solvent. The blood extract was directly injected onto an LC column. The chromatographic separation of the components was performed on a BEH C18 column (50 mm x 2.1 mm, 1.7 microm) using acetonitrile and water containing 0.1% formic acid. The mass spectrometer was operated in positive electrospray ion mode. Finally, the analysis was carried out with multiple reaction monitoring (MRM) mode. The limits of detection (LODs) for these three compounds were in the range of 0.1 to 2.0 ng/mL and the limits of quantification (LOQs) in the range of 0.5 to 5.0 ng/mL. Within the linear range, the correlation coefficients (r) of PEN G and its metabolites were all more than 0.9974. Accuracies for these targeted compounds were ranged from 92.3% to 105.5%, and the within-day precisions were less than 10%. The stabilities of the components were evaluated in the temperature range from 18 to 80 degrees C, and the mass concentration of penicillin G was decreased significantly with the extensions of storage temperature and storage time. Biological samples of the rats medicated with PEN G were analyzed using the developed method. The results show that PEN G can just be detected at 0.5 h after administration. However, the detection time limitation of penicilloic acid can be extended to 36 h. The established method has been further expanded for the applicability of forensic identification, and has a reference value for the detection of penicillin G residue in food.


Asunto(s)
Cromatografía Líquida de Alta Presión/métodos , Ácido Penicilánico/análogos & derivados , Penicilina G/análogos & derivados , Penicilina G/sangre , Espectrometría de Masas en Tándem/métodos , Animales , Femenino , Ácido Penicilánico/sangre , Penicilina G/metabolismo , Ratas
14.
PLoS One ; 6(10): e25308, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21991307

RESUMEN

When introduced in the 1950s, benzathine penicillin G (BPG) was shown to be effective in eradicating group A beta-hemolytic streptococcus (GAS) for at least 3 weeks after administration. Several studies since the 1990s suggest that at 3-4 weeks serum penicillin G levels are less than adequate (below MIC(90) of 0.016 µg/ml). We studied these levels for 4 weeks after the recommended dose of BPG in military recruits, for whom it is used as prophylaxis against GAS. The 329 subjects (mean age 20 years) each received 1.2 million units BPG IM and gave sera 1 day post injection and twice more at staggered time points over 4 weeks. Serum penicillin G levels were measured by liquid chromatography/tandem mass spectometry. The half-life of serum penicillin G was 4.1 days. By day 11, mean levels were <0.02 µg/ml, and by day 15<0.01 µg/ml. Levels in more than 50% of the subjects were below 0.02 µg/ml on day 9, and <.01 µg/ml on day 16. There was no demonstrable effect of subject body-surface area nor of the four different lots of BPG used. These data indicate that in healthy young adults serum penicillin G levels become less than protective <2½ weeks after injection of 1.2 million units of BPG. The findings require serious consideration in future medical and public health recommendations for treatment and prophylaxis of GAS upper respiratory tract infections.


Asunto(s)
Penicilina G/administración & dosificación , Penicilina G/sangre , Adolescente , Adulto , Intervalos de Confianza , Demografía , Relación Dosis-Respuesta a Droga , Humanos , Inyecciones Intramusculares , Masculino , Adulto Joven
15.
Rapid Commun Mass Spectrom ; 25(1): 25-32, 2011 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-21154651

RESUMEN

Liquid chromatography/mass spectrometry (LC/MS) and liquid chromatography/tandem mass spectrometry (LC/MS/MS) were applied to characterize drug metabolites. Although these two methods have overcome the identification and structural characterization of metabolites analysis, they remain time-consuming processes. In this study, a novel multiple-stage tandem mass spectrometric method (MS(n) ) was evaluated for identification and characterization of new minor metabolism profiling of penicillin G, one of the ß-lactam antibiotics, in human serum. Seven minor metabolites including five phase I metabolites and two phase II metabolites of penicillin G were identified by using data-dependent LC/MS(n) screening in one chromatographic run. The accuracy masses of seven identified metabolites of penicillin G were also confirmed by mass spectral calibration software (MassWorks™). The proposed data-dependent LC/MS(n) method is a powerful tool to provide large amounts of the necessary structural information to characterize minor metabolite in metabolism profiling.


Asunto(s)
Penicilina G/sangre , Espectrometría de Masas en Tándem/métodos , Cromatografía Liquida/métodos , Humanos , Redes y Vías Metabólicas , Ácido Penicilánico/análogos & derivados , Ácido Penicilánico/sangre , Ácido Penicilánico/química , Ácido Penicilánico/metabolismo , Penicilina G/química , Penicilina G/metabolismo
16.
Obstet Gynecol ; 112(2 Pt 1): 265-70, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18669721

RESUMEN

OBJECTIVE: Intrapartum penicillin G prophylaxis aims to prevent early-onset group B streptococci (GBS) sepsis by interrupting vertical transmission. We examined the relationship between duration of prophylaxis and fetal serum penicillin G levels among fetuses exposed to fewer than 4 hours of prophylaxis compared with longer durations. METHODS: In this prospective cohort study, 98 laboring GBS-positive women carrying singleton gestations at 37 weeks or greater were administered 5 million units of intravenous penicillin G followed by 2.5 million units every 4 hours until delivery. Umbilical cord blood samples were collected at delivery, and penicillin G levels were measured by high-performance liquid chromatography. Intraassay and interassay coefficients of variation were less than 3%. RESULTS: Fetuses exposed to fewer than 4 hours of prophylaxis had higher penicillin G levels than those exposed to greater than 4 hours (P=.003). In multivariable linear regression analysis, fetal penicillin G levels were determined by duration of exposure, time since last dose, dosage, and number of doses, but not maternal body mass index. Penicillin G levels increased linearly until 1 hour (R(2)=.40) and then decreased rapidly according to a power-decay model (R(2)=.67). All subgroups analyzed were above the minimal inhibitory concentration (MIC) for GBS (0.1 micrograms/mL)(P<.002). Individual samples were 10-179-fold above the MIC. In patients receiving maintenance dosing, penicillin G did not accumulate in the cord blood and returned to baseline after each 4-hour interval. CONCLUSION: Short durations of prophylaxis achieved levels significantly above the MIC, suggesting a benefit even in precipitous labors. The designation of infants exposed to fewer than 4 hours of prophylaxis as particularly at risk for GBS sepsis may be pharmacokinetically inaccurate.


Asunto(s)
Profilaxis Antibiótica , Sangre Fetal/química , Penicilina G/administración & dosificación , Penicilina G/sangre , Infecciones Estreptocócicas/prevención & control , Streptococcus agalactiae , Adulto , Profilaxis Antibiótica/métodos , Femenino , Feto/fisiología , Humanos , Modelos Lineales , Penicilina G/farmacocinética , Estudios Prospectivos , Infecciones Estreptocócicas/sangre
17.
J Biochem Biophys Methods ; 70(6): 992-8, 2008 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-17588670

RESUMEN

In this study, a capillary electrophoresis (CE) method was developed as a means to measure levels of penicillin G (PCN G) in Group B Streptococcus (GBS) positive pregnant women during labor and delivery. Volunteers for this developmental study were administered five million units of PCN G at the onset of labor. Urine, blood, and amniotic fluid samples were collected during labor and post delivery. Samples were semi-purified by solid-phase extraction (SPE) using Waters tC18 SepPak 3cc cartridges with a sodium phosphate/methanol step gradient for elution. Capillary electrophoresis or reversed-phase high-performance liquid chromatography (RP-HPLC) with diode-array absorbance detection were used to separate the samples in less than 30 min. Quantification was accomplished by establishing a calibration curve with a linear dynamic range. The tC18 SPE methodology provided substantial sample clean-up with high recovery yields of PCN G ( approximately 90%). It was found that SPE was critical for maintaining the integrity of the separation column when using RP-HPLC, but was not necessary for sample analysis by CE where no stationary phase is present. Quantification results ranged from millimolar concentrations of PCN G in maternal urine to micromolar concentrations in amniotic fluid. Serum and cord blood levels of PCN G were below quantification limits, which is likely due to the prolonged delay in sample collection after antibiotic administration. These results show that CE can serve as a simple and effective means to characterize the pharmacokinetic distribution of PCN G from mother to unborn fetus during labor and delivery. It is anticipated that similar methodologies have the potential to provide a quick, simple, and cost-effective means of monitoring the clinical efficacy of PCN G and other drugs during pregnancy.


Asunto(s)
Parto Obstétrico , Electroforesis Capilar/métodos , Feto/metabolismo , Trabajo de Parto , Penicilina G/análisis , Penicilina G/farmacocinética , Calibración , Femenino , Humanos , Interacciones Hidrofóbicas e Hidrofílicas , Penicilina G/administración & dosificación , Penicilina G/sangre , Penicilina G/orina , Embarazo , Streptococcus agalactiae/efectos de los fármacos
18.
Wiad Lek ; 59(1-2): 78-83, 2006.
Artículo en Polaco | MEDLINE | ID: mdl-16646298

RESUMEN

Benzylpenicillin (penicillin G) is a model drug for studies of drug-protein biochemical interactions. Furthermore the literature indicates that benzylpenicillin and protein conjugation is a universal phenomenon: benzylpenicillin is known to readily conjugate to proteins-serum albumin, globulin and others peptides to modify space structure and electrophoretical properties. The aim of the study was to test if the benzylpenicillin is an allosteric effector. Serum benzylpenicillin concentration in geometric progression was used. Then acid phosphatase (AcP), alanine aminotransferase (AIAT) activity and international normalized ratio (INR) was tested. Although benzylpenicillin influences AcP and INR, only AcP activity is directly proportional to the benzylpenicillin concentration (Pc): change of AcP activity was the derivative of Pc in 76% (R2 = 0.7635). Furthermore, the benzylpenicillin appears to be uncompetitive inhibitor of acid phosphatase (inhibitory constant Ki = 95.67M; Vmax = 34.843 nKat). On the contrary no effect of AIAT activity was observed. Unexpectedly INR was modified in irregular manner: in some concentrations of benzylpenicillin INR was over 25% lower than in control probe (INR approximately 0.6 vs. 0.82). Unfortunately INR > 6.5 is accepted as an early indicator of poor prognosis in fulminant hepatic failure. This phenomenon may be useful in sepsis as a prevention of disseminated intravascular coagulation (DIC). These data indicate that high benzylpenicillin concentration may be the cause of artifacts. The facts allow of interpretation that the allosteric effect of benzylpenicillin on enzymes activity is a possible mechanism of unpredictable adverse drug reactions (i.e. intolerance).


Asunto(s)
Antiinfecciosos/sangre , Antiinfecciosos/farmacología , Penicilina G/sangre , Penicilina G/farmacología , Regulación Alostérica/efectos de los fármacos , Humanos
19.
Artículo en Inglés | MEDLINE | ID: mdl-16257590

RESUMEN

Methods for the measurement of penicillin concentration in bovine plasma, kidney and urine were developed and validated. Detection was based on liquid chromatography/tandem mass spectrometry (LC/MS/MS). Phenethecillin was used as an internal standard. Plasma was extracted with acetonitrile using a method with a calculated limit of quantitation (LOQ) of 12 ng/mL. Kidney samples were homogenized in water and acetonitrile, then cleaned up on C18-bonded silica SPE cartridges. The LOQ of this procedure was 10 ng/g. Urine samples were diluted, filtered, and analyzed directly. The LOQ of this procedure was 63 ng/mL. The overall accuracy for plasma was 103% with coefficient of variation (CV) of 3%; for kidney, 96% and 11%, respectively, and for urine, 98% and 4%, respectively. These methods were applied to the analysis of plasma, urine, and kidney biopsy samples taken from standing animals that had been dosed with penicillin.


Asunto(s)
Cromatografía Liquida/métodos , Riñón/química , Espectrometría de Masas/métodos , Penicilina G/análisis , Animales , Biopsia , Bovinos , Riñón/patología , Penicilina G/sangre , Penicilina G/orina , Estándares de Referencia , Sensibilidad y Especificidad
20.
Chemistry ; 10(12): 2977-82, 2004 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-15214080

RESUMEN

Two penicillin derivatives, the active penamecillin and the inactive penamecillin-1beta-sulfoxide, were used to study the relationship between their charge density and their activity. Single crystals of both compounds were measured at the synchrotron beamline F1 at the HASYLAB/DESY, at 100 K and up to resolutions of around 0.4 A. Experimental charge densities were obtained by using the Hansen-Coppens multipole formalism. The cleavage of the amide bond in the beta-lactam ring is of paramount importance in the mechanism of action of penicillins. Topological analysis of this bond in terms of Bader's AIM theory showed that its strength is equal in both compounds; therefore a direct influence of bond strength on the activity can be ruled out. However, the two derivatives differ significantly in their experimental electrostatic potentials. These differences are discussed and provide further insight into the chemistry and activity of penicillins.


Asunto(s)
Penicilina G/análogos & derivados , Penicilina G/sangre , Sulfóxidos/química , Modelos Moleculares , Electricidad Estática , Relación Estructura-Actividad , Difracción de Rayos X
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