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1.
Pediatr Infect Dis J ; 40(5): 464-472, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33591074

RESUMO

BACKGROUND AND AIMS: Ampicillin is 1 of the most commonly used antibiotics for treatment of early onset sepsis, but its pharmacokinetics (PK) is poorly characterized. We aimed to define the dose of ampicillin for late preterm and term neonates by evaluating its PK in serum, cerebrospinal (CSF), and epithelial lining fluid. METHODS: A prospective study included neonates receiving ampicillin for suspected or proven early onset sepsis and pneumonia. PK samples were collected at steady state, at predose and 5 minutes, 1 hour, 3 hours, 8 hours, and 12 hours after ampicillin 3-minute infusion. Ampicillin concentrations were measured by ultra-high-performance liquid chromatography. Noncompartmental anaysis (NCA) and population pharmacokinetic (pop-PK) modeling were performed and probability of therapeutic target attainment was simulated. RESULTS: In 14 neonates (GA of 32-42 wks; mean BW 2873 g), PK parameters (mean ± SD) in NCA were the following: half-life 7.21 ± 7.97 hours; volume of distribution (Vd) 1.07 ± 0.51 L; clearance (CL) 0.20 ± 0.13 L/h; 24-hour area under the concentration-time curve 348.92 ± 114.86 mg*h/L. In pop-PK analysis, a 2-compartmental model described the data most adequately with the final parameter estimates of CL 15.15 (CV 40.47%) L/h/70kg; central Vd 24.87 (CV 37.91%) L/70kg; intercompartmental CL 0.39 (CV 868.56) L/h and peripheral Vd 1.039 (CV 69.32%) L. Peutic target attainment simulations demonstrated that a dosage of 50 mg/kg q 12 hours attained 100% fT > MIC 0.25 mg/L, group B streptococcal breakpoint. CONCLUSIONS: We recommend ampicillin dosage 50 mg/kg q 12 hours for neonates with gestational age ≥32 weeks during the first week of life.


Assuntos
Ampicilina/farmacocinética , Antibacterianos/farmacocinética , Recém-Nascido , Sepse Neonatal/tratamento farmacológico , Ampicilina/administração & dosagem , Ampicilina/sangue , Ampicilina/líquido cefalorraquidiano , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Antibacterianos/líquido cefalorraquidiano , Modelos Epidemiológicos , Idade Gestacional , Humanos , Testes de Sensibilidade Microbiana , Modelos Estatísticos , Estudos Prospectivos
2.
Rapid Commun Mass Spectrom ; 34(7): e8601, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32043669

RESUMO

RATIONALE: Paper spray mass spectrometry (PS-MS) was used to analyze and quantify ampicillin, a hydrophilic compound and frequently utilized antibiotic. Hydrophilic molecules are difficult to analyze via PS-MS due to their strong binding affinity to paper substrates and low ionization efficiency, among other reasons. METHODS: Solvent and paper parameters were optimized to increase the extraction of ampicillin from the paper substrate. After optimizing these key parameters, a Resolution IV 1/16 fractional factorial design with two center points was employed to screen eight different design parameters simultaneously. RESULTS: Pore size, sample volume, and solvent volume were the most significant factors affecting average peak area under the curve (AUC) and the signal-to-blank (S/B) ratio for the 1 µg/mL ampicillin calibrant. After optimizing the key parameters, a linear calibration curve with a range of 0.2 µg/mL to 100 µg/mL was generated (R2  = 0.98) and the limit of detection (LOD) and lower limit of quantification (LLOQ) were calculated to be 0.07 µg/mL and 0.25 µg/mL, respectively. CONCLUSIONS: The statistical optimization procedure undertaken here increased the mass spectral signal intensity by more than a factor of 40. This statistical method of screening followed by optimization experiments proved faster and more efficient, and produced more drastic improvements than typical one-factor-at-a-time experiments.


Assuntos
Ampicilina/sangue , Antibacterianos/sangue , Ampicilina/análise , Antibacterianos/análise , Área Sob a Curva , Teste em Amostras de Sangue Seco/métodos , Humanos , Limite de Detecção , Espectrometria de Massas/métodos , Papel , Solventes/química
4.
Biosens Bioelectron ; 132: 8-16, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30851495

RESUMO

We designed and synthesized a novel covalent organic framework (COF) by condensation polymerization of 1,3,6,8-tetrakis(4-formylphenyl)pyrene and melamine through imine bonds (represented by Py-M-COF). The basic characterizations revealed that the Py-M-COF not only exhibited an extended π-conjugation framework, a large specific surface area (495.5 m2 g-1), big pore cavities, and nanosheet-like structure but also possessed rich functional groups, such as CË­C, CË­N, CË­O, and NH2. These features endowed the Py-M-COF with high charge carrier mobility, further improving the strong immobilization of DNA aptamer strands via π-π stacking interaction and electrostatic interaction. As such, the Py-M-COF-based electrochemical aptasensors are ultrasensitive in detecting different antibiotics, including enrofloxacin (ENR) and ampicillin (AMP), yielding extremely low detection limits of 6.07 and 0.04 fg mL-1 (S/N = 3) toward ENR and AMP, respectively, along with other excellent sensing performances. This biosensing platform based on Py-M-COF has potential applications for the sensitive detection of antibiotics or other analytes by replacing the corresponding aptamers.


Assuntos
Antibacterianos/sangue , Aptâmeros de Nucleotídeos/química , Técnicas Biossensoriais/métodos , Técnicas Eletroquímicas/métodos , Pirenos/química , Triazinas/química , Ampicilina/análise , Ampicilina/sangue , Antibacterianos/análise , Enrofloxacina/análise , Enrofloxacina/sangue , Humanos , Ácidos Nucleicos Imobilizados/química , Limite de Detecção , Modelos Moleculares , Polimerização , Reprodutibilidade dos Testes
5.
Talanta ; 176: 619-624, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-28917799

RESUMO

We report the design and fabrication of a "signal-on" electrochemical aptamer-based (E-AB) sensor for detection of ampicillin. The signaling of the sensor is based on target binding-induced changes in the conformation and flexibility of the methylene blue-modified aptamer probe. The sensor's response is fast; signal saturation can be reached in ~ 200s. Since all the sensor components are surface-immobilized, it is regenerable and can be reused for at least three times. It has demonstrated good specificity and is capable of differentiating between ampicillin and structurally similar antibiotics such as amoxicillin. More importantly, it is selective enough to be employed directly in complex samples, including serum, saliva, and milk. Although both alternating current voltammetry (ACV) and square wave voltammetry (SWV) are suitable sensor characterization techniques, our results show that ACV is better suited for target analysis. Even under the optimal experimental conditions, the limit of detection of the sensor obtained in ACV (1µM) is significantly lower than that obtained in SWV (30µM).


Assuntos
Ampicilina/análise , Antibacterianos/análise , Aptâmeros de Nucleotídeos/química , Técnicas Eletroquímicas , Ampicilina/sangue , Ampicilina/química , Animais , Antibacterianos/sangue , Antibacterianos/química , Bovinos , Humanos , Azul de Metileno/química , Leite/química , Saliva/química , Compostos de Sulfidrila/química
6.
Ther Drug Monit ; 40(1): 103-108, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29271816

RESUMO

BACKGROUND: Dried blood spot (DBS) is a practical sampling strategy for pharmacokinetic studies in neonates. The utility of DBS to determine the population pharmacokinetics (pop-PK) of ampicillin, as well as accuracy versus plasma samples, was evaluated. METHODS: An open-label, multicenter, opportunistic, prospective study was conducted in neonates. Ampicillin concentrations from plasma and DBS (CONCPlasma and CONCDBS) were measured by liquid chromatographic tandem mass spectrometry and analyzed using pop-PK and statistical (including transformation) approaches. RESULTS: A total of 29 paired plasma and DBS samples from 18 neonates were analyzed. The median (range) gestational age and postnatal age were 37 (27-41) weeks and 8 (1-26) days, respectively. The geometric mean of CONCDBS to CONCPlasma ratio was 0.56. Correlation analysis demonstrated strong association between CONCPlasma and CONCDBS (r = 0.902, analysis of variance P < 0.001). Using linear regression transformation, the estimated CONCPlasma (eCONCPlasma) was derived using (CONCDBS - 3.223)/0.51. The median bias and geometric mean ratio improved to -11% and 0.88 (Wilcoxon signed-rank test, P < 0.001), respectively, when comparing eCONCPlasma to CONCPlasma. Furthermore, using pop-PK modeling, the median bias (interquartile range) for clearance and individual predicted concentrations improved to 8% (-11 to 50) and -8% (-34 to 11), respectively, when eCONCPlasma was used. CONCLUSIONS: After transformation, DBS sampling accurately predicted ampicillin exposure in neonates.


Assuntos
Ampicilina/farmacocinética , Teste em Amostras de Sangue Seco/métodos , Ampicilina/sangue , Cromatografia Líquida , Feminino , Humanos , Recém-Nascido , Masculino , Modelos Biológicos , Estudos Prospectivos , Espectrometria de Massas em Tandem
7.
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
8.
Eur J Pharm Sci ; 107: 249-255, 2017 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-28709912

RESUMO

The pharmaceutical excipient, polyethylene glycol 400 (PEG 400), unexpectedly alters the bioavailability of the BCS class III drug ranitidine in a sex-dependent manner. As ranitidine is a substrate for the efflux transporter P-glycoprotein (P-gp), we hypothesized that the sex-related influence could be due to interactions between PEG 400 and P-gp. In this study, we tested this hypothesis by: i) measuring the influence of PEG 400 on the oral bioavailability of another P-gp substrate (ampicillin) and of a non-P-gp substrate (metformin); and ii) measuring the effect of PEG 400 on drug bioavailability in the presence of a P-gp inhibitor (cyclosporine A) in male and female rats. We found that PEG 400 significantly increased (p<0.05) the bioavailability of ampicillin (the P-gp substrate) in male rats, but not in female ones. In contrast, PEG 400 had no influence on the bioavailability of the non-P-gp substrate, metformin in male or female rats. Inhibition of P-gp by oral pre-treatment with cyclosporine A increased the bioavailability of the P-gp substrates (ampicillin and ranitidine) in males and females (p<0.05), and to a greater extent in males, but had no influence on the bioavailability of metformin in either male or female rats. These results prove the hypothesis that the sex-specific effect of PEG 400 on the bioavailability of certain drugs is due to the interaction of PEG 400 with the efflux transporter P-gp.


Assuntos
Ampicilina/farmacocinética , Excipientes/farmacologia , Metformina/farmacocinética , Polietilenoglicóis/farmacologia , Ranitidina/farmacocinética , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/antagonistas & inibidores , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Ampicilina/sangue , Animais , Disponibilidade Biológica , Ciclosporina/farmacologia , Feminino , Masculino , Metformina/sangue , Ranitidina/sangue , Ratos Wistar , Fatores Sexuais
9.
Artigo em Inglês | MEDLINE | ID: mdl-28052852

RESUMO

Acinetobacter baumannii is emerging with resistance to polymyxins. In 24-h time-kill experiments, high-dose ampicillin-sulbactam in combination with meropenem and polymyxin B achieved additivity or synergy against 108 CFU/ml of two clinical A. baumannii isolates resistant to all three drugs (maximum reductions, 1.6 and 3.1 logs). In a 14-day hollow-fiber infection model, high-dose ampicillin-sulbactam (8/4 g every 8 h, respectively) in combination with meropenem (2 g every 8 h) and polymyxin B (1.43 mg/kg of body weight every 12 h with loading dose) resulted in rapid (96 h) eradication of A. baumannii.


Assuntos
Acinetobacter baumannii/efeitos dos fármacos , Antibacterianos/farmacocinética , Modelos Estatísticos , Polimixina B/farmacocinética , Tienamicinas/farmacocinética , Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/crescimento & desenvolvimento , Ampicilina/sangue , Ampicilina/farmacocinética , Antibacterianos/sangue , Área Sob a Curva , Disponibilidade Biológica , Índice de Massa Corporal , Esquema de Medicação , Combinação de Medicamentos , Cálculos da Dosagem de Medicamento , Farmacorresistência Bacteriana Múltipla , Sinergismo Farmacológico , Humanos , Meropeném , Testes de Sensibilidade Microbiana , Polimixina B/sangue , Sulbactam/sangue , Sulbactam/farmacocinética , Tienamicinas/sangue
10.
BMC Microbiol ; 16(1): 205, 2016 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-27599570

RESUMO

BACKGROUND: This study evaluated how dosing regimen for intramuscularly-administered ampicillin, composition of Escherichia coli strains with regard to ampicillin susceptibility, and excretion of bacteria from the intestine affected the level of resistance among Escherichia coli strains in the intestine of nursery pigs. It also examined the dynamics of the composition of bacterial strains during and after the treatment. The growth responses of strains to ampicillin concentrations were determined using in vitro growth curves. Using these results as input data, growth predictions were generated using a mathematical model to simulate the competitive growth of E. coli strains in a pig intestine under specified plasma concentration profiles of ampicillin. RESULTS: In vitro growth results demonstrated that the resistant strains did not carry a fitness cost for their resistance, and that the most susceptible strains were more affected by increasing concentrations of antibiotics that the rest of the strains. The modeling revealed that short treatment duration resulted in lower levels of resistance and that dosing frequency did not substantially influence the growth of resistant strains. Resistance levels were found to be sensitive to the number of competing strains, and this effect was enhanced by longer duration of treatment. High excretion of bacteria from the intestine favored resistant strains over sensitive strains, but at the same time it resulted in a faster return to pre-treatment levels after the treatment ended. When the duration of high excretion was set to be limited to the treatment time (i.e. the treatment was assumed to result in a cure of diarrhea) resistant strains required longer time to reach the previous level. CONCLUSION: No fitness cost was found to be associated with ampicillin resistance in E. coli. Besides dosing factors, epidemiological factors (such as number of competing strains and bacterial excretion) influenced resistance development and need to be considered further in relation to optimal treatment strategies. The modeling approach used in the study is generic, and could be used for prediction of the effect of treatment with other drugs and other administration routes for effect on resistance development in the intestine of pigs.


Assuntos
Ampicilina/farmacologia , Ampicilina/farmacocinética , Infecções por Escherichia coli/tratamento farmacológico , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Escherichia coli/patogenicidade , Intestinos/microbiologia , Ampicilina/administração & dosagem , Ampicilina/sangue , Animais , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Antibacterianos/farmacocinética , Antibacterianos/farmacologia , Carga Bacteriana , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Injeções Intramusculares/métodos , Testes de Sensibilidade Microbiana/métodos , Modelos Teóricos , Suínos , Fatores de Tempo
11.
Int J Clin Pharm ; 38(4): 771-5, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27001408

RESUMO

Background The administration of antibiotic prophylaxis during cardiothoracic surgery can reduce the rate of surgical site infections. Trials of cardiothoracic antibiotic prophylaxis have found it to be beneficial in preventing postoperative wound infections. Objective To determine the more appropriate timing of repeated doses of ampicillin-sulbactam to maintain adequate antibiotic concentrations during cardiovascular surgery in anuric patients. Method Five adult anuric dialysis patients who received ampicillin-sulbactam during cardiovascular surgery at Kagoshima University Hospital, the total plasma concentrations of ampicillin and sulbactam were monitored after ampicillin (1 g)-sulbactam (0.5 g) administration. Pharmacokinetic parameters were estimated and used to predict the free plasma concentrations of ampicillin and sulbactam. Results The mean values for the volume of distribution, total clearance, elimination rate constant and the elimination half-life for ampicillin were 8.9 ± 2.4 L, 1.69 ± 0.93 L/h, 0.180 ± 0.059 h(-1) and 4.23 ± 1.48 h, respectively. The pharmacokinetic parameters were similar to those of sulbactam. When ampicillin (1 g)-sulbactam (0.5 g) was intravenously administered at 8, 12 and 24 h intervals, the predicted free trough plasma concentrations of ampicillin were 28.72, 12.06 and 1.25 µg/mL, respectively. Conclusion We suggest that ampicillin (1 g)-sulbactam (0.5 g) should be intravenously administered every 12 h in order to maintain a free ampicillin concentration of more than 12 µg/mL in anuric patients during cardiovascular surgery.


Assuntos
Anuria/tratamento farmacológico , Procedimentos Cirúrgicos Cardiovasculares/métodos , Esquema de Medicação , Idoso , Ampicilina/sangue , Ampicilina/farmacocinética , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Humanos , Masculino , Sulbactam/sangue , Sulbactam/farmacocinética
12.
Biol Pharm Bull ; 38(11): 1817-21, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26521833

RESUMO

UNLABELLED: Antibiotic concentrations must be maintained at an adequate level throughout cardiovascular surgery to prevent surgical site infection. This study aimed to determine the most appropriate timing for intraoperative repeated dosing of ampicillin-sulbactam, a commonly used antibiotic prophylaxis regimen, to maintain adequate concentrations throughout the course of cardiovascular surgery with cardiopulmonary bypass (CPB). The total plasma concentrations of ampicillin were monitored in 8 patients after ampicillin (1 g)-sulbactam (0.5 g) administration via initial intravenous infusion and subsequent CPB priming. Pharmacokinetic parameters were estimated and used to predict the free plasma concentrations of ampicillin. The mean values for the volume of distribution, elimination rate constant, elimination half-life, and total clearance of ampicillin were 15.8±4.1 L, 0.505±0.186 h(-1), 1.52±0.47 h, and 7.72±2.72 L/h, respectively. When ampicillin (1 g)-sulbactam (0.5 g) was intravenously administered every 3, 4, 6, and 12 h after the start of CPB, the predicted free trough plasma concentrations of ampicillin were 15.20, 8.25, 2.74, and 0.13 µg/mL, respectively. Therefore, an every-6-h regimen was needed to maintain the free ampicillin concentration at more than 2 µg/mL during cardiovascular surgery with CPB. We suggest that the dose and dosing interval for ampicillin-sulbactam should be adjusted to optimize the efficacy and safety of treatment, according to the minimum inhibitory concentrations for methicillin-sensitive Staphylococcus aureus isolates at each institution. REGISTRATION NUMBER: UMIN000007356.


Assuntos
Antibacterianos/administração & dosagem , Ponte Cardiopulmonar , Complicações Pós-Operatórias/prevenção & controle , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/efeitos dos fármacos , Idoso , Ampicilina/administração & dosagem , Ampicilina/sangue , Ampicilina/farmacocinética , Ampicilina/uso terapêutico , Antibacterianos/sangue , Antibacterianos/farmacocinética , Antibacterianos/uso terapêutico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Esquema de Medicação , Feminino , Meia-Vida , Humanos , Infusões Intravenosas , Injeções Intravenosas , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Complicações Pós-Operatórias/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/crescimento & desenvolvimento , Sulbactam/administração & dosagem , Sulbactam/sangue , Sulbactam/farmacocinética , Sulbactam/uso terapêutico
13.
Angew Chem Int Ed Engl ; 54(25): 7359-62, 2015 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-25939633

RESUMO

The extraction of target analytes from biological samples is a bottleneck in analysis. A microfluidic device featuring an electrokinetic size and mobility trap was formed by two nanojunctions of different pore size to extract and concentrate analytical targets from complex samples. The trap was seamlessly coupled with electrophoretic separation for quantitative analysis. The device was applied to the analysis of ampicillin levels in blood within 5 min and a linear response over the range of 2.5-20 µg mL(-1). This covers the recommended levels for treating sepsis, a critical condition with 30 to 50% mortality and unpredicted drug levels. The device provides a new opportunity for on-site therapeutic drug monitoring, which should enable quick and accurate dosing and may save lives in such critical conditions.


Assuntos
Ampicilina/sangue , Antibacterianos/sangue , Monitoramento de Medicamentos/instrumentação , Eletroforese/instrumentação , Técnicas Analíticas Microfluídicas/instrumentação , Desenho de Equipamento , Humanos
14.
J Vet Pharmacol Ther ; 38(4): 330-5, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25376083

RESUMO

The objective of this study was to determine the disposition of ampicillin in plasma, uterine tissue, lochial fluid, and milk of postpartum dairy cattle. Ampicillin trihydrate was administered by intramuscular (i.m.) injection at a dose of 11 mg/kg of body weight every 24 h (n = 6, total of 3 doses) or every 12 h (n = 6, total of 5 doses) for 3 days. Concentrations of ampicillin were measured in plasma, uterine tissue, lochial fluid, and milk using HPLC with ultraviolet absorption. Quantifiable ampicillin concentrations were found in plasma, milk, and lochial fluid of all cattle within 30 min, 4 h, and 4 h of administration of ampicillin trihydrate, respectively. There was no significant effect of dosing interval (every 12 vs. every 24 h) and no significant interactions between dosing interval and sampling site on the pharmacokinetic variable measured or calculated. Median peak ampicillin concentration at steady-state was significantly higher in lochial fluid (5.27 µg/mL after q 24 h dosing) than other body fluids or tissues and significantly higher in plasma (3.11 µg/mL) compared to milk (0.49 µg/mL) or endometrial tissue (1.55 µg/mL). Ampicillin trihydrate administered once daily by the i.m. route at the label dose of 11 mg/kg of body weight achieves therapeutic concentrations in the milk, lochial fluid, and endometrial tissue of healthy postpartum dairy cattle.


Assuntos
Ampicilina/farmacocinética , Líquidos Corporais/química , Bovinos/metabolismo , Leite/química , Período Pós-Parto/fisiologia , Útero/metabolismo , Ampicilina/sangue , Animais , Antibacterianos/sangue , Antibacterianos/farmacocinética , Bovinos/sangue , Feminino , Distribuição Tecidual , Útero/química
15.
J Infect Chemother ; 20(10): 653-5, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24972584

RESUMO

Intravenous ampicillin has been extensively used for various kinds of infections for more than fifty years. This drug is administered intermittently, which can result in missed or delayed drug administration and sleep interruption that can have a negative impact on the quality of life during hospitalization. Continuous infusion may solve these concerns. We reviewed the cases of five patients who were treated with continuous ampicillin infusions in our hospital. The ampicillin serum concentrations were from 11.3 to 32.8 µg/mL, which was above the ampicillin MICs of the causative organisms, ≤0.06 to 4 µg/mL. Although the dosages given of ampicillin varied in each case, the serum concentrations showed a strong correlation with creatinine clearance (r(2) = 0.91). All the patients improved at the time of discharge, or transfer to another hospital, with no significant complications during the continuous infusion. Continuous ampicillin infusion could be a better alternative for frequent intermittent infusion for adult inpatients with infections due to ampicillin-susceptible organisms.


Assuntos
Ampicilina/administração & dosagem , Ampicilina/sangue , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Idoso , Idoso de 80 Anos ou mais , Creatinina/sangue , Creatinina/urina , Endocardite Bacteriana/tratamento farmacológico , Feminino , Humanos , Infusões Intravenosas , Masculino , Meningites Bacterianas/tratamento farmacológico , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Espondilite/tratamento farmacológico
16.
Transfusion ; 54(10): 2505-13, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24724982

RESUMO

BACKGROUND: Antibiotic prophylaxis treatment at delivery is highly recommended for reducing the risk of infection for mothers positive for group B streptococcus. It is therefore expected that some cord blood (CB) products will contain residual antibiotics. This study aimed to determine the incidence and level of ß-lactam antibiotics in CB products. STUDY DESIGN AND METHODS: The antimicrobial activity of 60 CB plasma by-products was evaluated using disk diffusion assays on 10 bacteria species. Plasma samples showing antimicrobial activity were either treated with ß-lactamase enzyme to inhibit ß-lactam antibiotics or heated to 56°C for 30 minutes to inhibit complement proteins. ß-Lactam antibiotic concentrations were determined by comparison with a standard curve obtained with known concentrations of antibiotics. RESULTS: Antimicrobial activity against mostly Gram-positive microorganisms was observed in 33% of CB units. The ß-lactamase enzyme abolished the antimicrobial activity in the majority of these CB products. Up to 5 µg/mL penicillin and 14 µg/mL ampicillin were measured in these products. CONCLUSION: Approximately one-third of CB products contain significant amounts of plasma with residual antibiotics, which can affect the survival and growth of bacterial contaminants when performing the sterility test and potentially lead to false-negative results. Additional work is required to better understand whether residual antibiotics in CB affect penicillin-allergic patients.


Assuntos
Anti-Infecciosos/sangue , Sangue Fetal/microbiologia , Ampicilina/sangue , Ampicilina/farmacologia , Anti-Infecciosos/farmacologia , Antibioticoprofilaxia/estatística & dados numéricos , Doadores de Sangue/estatística & dados numéricos , Ativação do Complemento , Relação Dose-Resposta a Droga , Sangue Fetal/efeitos dos fármacos , Células-Tronco Hematopoéticas/citologia , Células-Tronco Hematopoéticas/efeitos dos fármacos , Humanos , Recém-Nascido , Penicilinas/sangue , Penicilinas/farmacologia , beta-Lactamases/metabolismo
17.
J Vet Pharmacol Ther ; 37(5): 445-50, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24666465

RESUMO

The pharmacokinetics of ampicillin in dogs was determined after intravenous (i.v.) bolus and constant rate infusion. Ampicillin was administered to six beagle dogs as an i.v. bolus at 20 mg/kg and as a constant rate i.v. infusion (CRI) at 20 mg/kg during 8 h (0.042 mL/min/kg) in Ringer's lactate (Hartmann's) solution. The concentrations were determined by an LC/MS/MS method. After i.v. bolus, ampicillin total body clearance, apparent volume of distribution at steady-state, mean residence time (MRT), and half-life were 4.53 ± 0.70 mL/min/kg, 0.275 ± 0.044 L/kg, 61 ± 13 min, and 111 (85-169) min, respectively. The corresponding parameters calculated after CRI were 13.5 ± 1.06 mL/min/kg, 0.993 ± 0.415 L/kg, 73 ± 27 min, and 49 (31-69) min. Ampicillin concentration decreased by 30% in the Ringer's lactate infusion solution mostly during the first hour after preparation of the solution. Constant rate infusion of Ringer's lactate solution during 8 h caused significant changes in ampicillin pharmacokinetics. The results suggested that special attention should be given to drug pharmacokinetics when co-administered intravenously with electrolyte solutions.


Assuntos
Ampicilina/farmacocinética , Antibacterianos/farmacocinética , Cães/sangue , Eletrólitos/administração & dosagem , Ampicilina/administração & dosagem , Ampicilina/sangue , Animais , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Área Sob a Curva , Interações Medicamentosas , Meia-Vida
18.
Br J Clin Pharmacol ; 77(3): 509-21, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24102758

RESUMO

AIMS: The aims of this study were to develop a population pharmacokinetic (PK) model of ampicillin and sulbactam, to identify patient characteristics influencing the PK, and to explore the relationship between dose regimen and degree of renal impairment with exposure and time above minimum inhibitory concentration (MIC). METHODS: This analysis was performed on PK data for ampicillin and sulbactam and MIC data from a clinical trial in Japanese patients with community acquired pneumonia. Simulations were performed to investigate the effects of different dosing intervals on exposure and time above MIC in various degrees of renal impairment. RESULTS: The plasma concentrations from 47 patients were adequately described by a two compartment model with simultaneous fit of ampicillin and sulbactam PK data, where creatinine clearance on clearance and body weight on volume in the peripheral compartment were identified as covariates for both drugs. Creatinine clearance contributed to reducing inter-individual variability of clearance by 16%. Mean clearance (inter-individual variability) for ampicillin and sulbactam was estimated to be 10.7 l h(-1) (14.8%) and 10.4 l h(-1) (15.2%), respectively. The time above MIC for each pathogen was generally > 50% of the treatment period. Simulations for exposure and time above MIC supported currently recommended dose adjustments. CONCLUSIONS: This study provided a PK model for ampicillin and sulbactam, the time above MICs for identified pathogens and associated simulation results. These findings provide useful information and augment evidence for the established dosage regimens in patients with various degrees of renal impairment.


Assuntos
Ampicilina/farmacocinética , Antibacterianos/farmacocinética , Infecções Comunitárias Adquiridas/tratamento farmacológico , Nefropatias/complicações , Rim/fisiopatologia , Pneumonia Bacteriana/tratamento farmacológico , Sulbactam/farmacocinética , Adulto , Idoso , Idoso de 80 Anos ou mais , Ampicilina/administração & dosagem , Ampicilina/sangue , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Infecções Comunitárias Adquiridas/sangue , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/microbiologia , Simulação por Computador , Esquema de Medicação , Combinação de Medicamentos , Cálculos da Dosagem de Medicamento , Feminino , Humanos , Infusões Intravenosas , Japão , Nefropatias/sangue , Nefropatias/fisiopatologia , Masculino , Taxa de Depuração Metabólica , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Modelos Biológicos , Pneumonia Bacteriana/sangue , Pneumonia Bacteriana/complicações , Pneumonia Bacteriana/microbiologia , Sulbactam/administração & dosagem , Sulbactam/sangue
19.
Intern Med ; 52(10): 1131-5, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23676604

RESUMO

Aminoglycosides are useful antimicrobial agents for treating infective endocarditis; however, they occasionally cause troublesome side effects, such as nephrotoxicity and ototoxicity. We herein report a case of infective endocarditis caused by Enterococcus faecalis that was treated successfully with continuous infusion of ampicillin without adjunctive aminoglycosides. The serum ampicillin concentrations were higher than the minimal inhibitory concentration for the target strain. Although the use of ampicillin monotherapy is currently avoided because double ß-lactam therapy is reportedly more effective, continuous penicillin administration remains an effective therapeutic choice for treating infective endocarditis.


Assuntos
Ampicilina/uso terapêutico , Antibacterianos/uso terapêutico , Endocardite Bacteriana/tratamento farmacológico , Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Idoso , Aminoglicosídeos/efeitos adversos , Ampicilina/administração & dosagem , Ampicilina/sangue , Ampicilina/farmacologia , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Antibacterianos/farmacologia , Anticoagulantes/uso terapêutico , Artroplastia de Quadril , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Contraindicações , Diagnóstico Diferencial , Endocardite Bacteriana/sangue , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Fraturas do Colo Femoral/cirurgia , Infecções por Bactérias Gram-Positivas/sangue , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Infusões Intravenosas , Masculino , Testes de Sensibilidade Microbiana , Valva Mitral/microbiologia , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/microbiologia , Guias de Prática Clínica como Assunto , Pielonefrite/diagnóstico , Estreptomicina , Varfarina/uso terapêutico
20.
J Pharm Biomed Anal ; 73: 59-64, 2013 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-22559990

RESUMO

A limited number of studies with application of the Arrhenius equation have been reported to drugs and biopharmaceuticals in biological fluids at frozen temperatures. This paper describes stability studies of ampicillin and cephalexin in aqueous solution and human plasma applying the Arrhenius law for determination of adequate temperature and time of storage of these drugs using appropriate statistical analysis. Stability studies of the beta-lactams in human plasma were conducted at temperatures of 20°C, 2°C, -20°C and also during four cycles of freeze-thawing. Chromatographic separation was achieved using a Shimpak C(18) column, acetonitrile as organic modifier and detection at 215nm. LC-UV-MS/MS was used to demonstrate the conversion of ampicillin into two diastereomeric forms of ampicilloic acid. Stability studies demonstrated degradation greater than 10% for ampicillin in human plasma at 20°C, 2°C and -20°C after 15h, 2.7days, 11days and for cephalexin at the same temperatures after 14h, 3.4days and 19days, respectively, and after the fourth cycle of freezing-thawing. The Arrhenius plot showed good prediction for the ideal temperature and time of storage for ampicillin (52days) and cephalexin (151days) at a temperature of -40°C, but statistical analysis (least squares method) must be applied to avoid incorrect extrapolations and estimated values out uncertainty limits.


Assuntos
Ampicilina/sangue , Antibacterianos/sangue , Cefalexina/sangue , Modelos Químicos , Ampicilina/química , Antibacterianos/química , Cefalexina/química , Cromatografia Líquida de Alta Pressão , Temperatura Baixa , Interpretação Estatística de Dados , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Humanos , Análise dos Mínimos Quadrados , Modelos Lineares , Estrutura Molecular , Espectrometria de Massas em Tandem , Fatores de Tempo
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