Apichat Phetmoreekul . Pharmacodynamic comparison of levofloxacin gatifloxacin and moxifloxacin against bacterial causing human sinusitis in an in vitro pharmacodynamic model. Master's Degree(Pharmacology). Chulalongkorn University. : Chulalongkorn University, 2003.
Pharmacodynamic comparison of levofloxacin gatifloxacin and moxifloxacin against bacterial causing human sinusitis in an in vitro pharmacodynamic model
Abstract:
An in vitro pharmacokinetic model (IVPM) was used to simulate the peak concentration (C[subscript max]) of Levofloxacin, Gatifloxacin and Moxifloxacin in human maxillary sinus, when administrate 500, 400 and 400 mg, respectively by oral rout once daily in single dose and multiple doses regimen, against 6 strains of microorganisms causing human maxillary sinusitis such as M.catarrhalis, H.influenzae and S.pneumoniae. The concentration was decreased depend on the elimination half-life in each agents. The results from this experiment exhibit the single dose regimen of Moxifloxacin and Gatifloxacin demonstrated rapid killing of all 6 strains of microorganisms. Moxifloxacin and Gatifloxacin, which have AUC[subscript 0-24]/MIC in the range of 155.39-189.50 and 125.36-259.12 respectively and Peak/MIC in the range of 12.14-15.10 and 14.14-28.44, respectively could decrease 99.9% viable count of S.pneumoniae within 2 hours and decrease this microorganism to eradicate within 4-6 hours faster than Levofloxacin, which have AUC[subscript 0-24]/MIC in the range of 67.21-1270.80 and Peak/MIC in the range of 6.60-145.20. Levofloxacin, Gatifloxacin and Moxifloxacin, which have AUC[subscript 0-24]/MIC in the range of 4515.33-9034.61, 2187.66-19862.85 and 1607.80-50420.00, respectively and Peak/MIC in the range of 483.33-919.23, 237.86-1980.00 and 116.20-4433.33, respectively, against M.catarrhalis and H.influenzae demonstrated the similar killing rate for these microorganisms. The multiple doses regimen of Moxifloxacin and Gatifloxacin, which have AUC[subscript 0-24]/MIC in the range of 164.14-209.90 and 150.66-330.80, respectively and Peak/MIC in the range of 13.10-15.77 and 16.24-32.96 respectively, demonstrated the 99.9% viable count of S.pneumoniae decrease which was more than single dose regimen. For Levofloxacin, which have AUC[subscript 0-24]/MIC in the range of 70.70-1399.40 and Peak/MIC in the range of 6.99-137.80, demonstrated killing these microorganisms as the same rate as single dose regimen. Moxifloxacin and Gatifloxacin, which have AUC[subscript 0-24]/MIC in the range of 1653.80-57680.00 and 2583.66-22237.14 respectively and Peak/MIC in the range of 137.20-4553.33 and 292.33-2440.00 respectively, demonstrated killing M.catarrhalis and H.influenzae faster than single dose regimen. While Levofloxacin, which have AUC[subscript 0-24/MIC in the range of 4340.66-9357.69 and Peak/MIC in the range 463.33-967.94, demonstrated killing these microorganisms as the same rate as single dose regimen. The summary, Moxifloxacin and Gatifloxacin single dose regimen demonstrated killing S.pneumoniae faster than Levofloxacin. While efficacy of Levofloxacin, Gatifloxacin and Moxifloxacin against M.catarrhalis and H.influenzae demonstrated not difference. About Moxifloxacin and Gatifloxacin, when administration multiple doses regimen, decreased all 6 strains of microorganisms faster than single dose regimen. In the contrast Levofloxacin multiple doses regimen demonstrated similar killing rate with single dose regimen