Pharmacodynamics of doxycycline for chemoprophylaxis of Lyme disease: preliminary findings and possible implications for other antimicrobials.
Int J Antimicrob Agents
; 31(3): 235-9, 2008 Mar.
Article
em En
| MEDLINE
| ID: mdl-18226504
ABSTRACT
The purpose of this study was to begin to characterise the pharmacodynamic parameters of single-dose doxycycline for the prevention of Lyme disease following a tick bite. Based on limited data from published human and murine studies, it was found that there is a direct correlation between efficacy rate and the area under the time-concentration of free antibiotic curve divided by the minimum inhibitory concentration (fAUC/MIC) (R(2)=0.74, using Pearson correlation), but not the maximum concentration of free drug in serum divided by the MIC (fC(max)/MIC) or the time that the free drug concentration remains above the MIC (fT>MIC). To determine the possible implications of these findings for other antimicrobials, it was assumed that the pharmacodynamic properties of doxycycline would be pertinent to azithromycin, an antibiotic whose activity is known to correlate with AUC/MIC. By making such an extrapolation and using pharmacokinetic modelling with conservative assumptions on MIC values against Borrelia burgdorferi, it is hypothesised that a single 500 mg dose of azithromycin in humans should have comparable efficacy to doxycycline for the prevention of Lyme disease. Additional experimental studies are needed to clarify more precisely the pharmacodynamic properties of doxycycline and to validate the accuracy of this hypothesis.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença de Lyme
/
Doxiciclina
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Quimioprevenção
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Borrelia burgdorferi
/
Antibacterianos
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Animals
/
Humans
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article