Document Detail


Duration and clinical relevance of postantibiotic effect in relation to the dosing interval.
MedLine Citation:
PMID:  9559777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The influence of half-life on the postantibiotic effect (PAE) of tobramycin against Pseudomonas aeruginosa and Staphylococcus aureus was investigated during one dosing interval. Tobramycin half-lives of 0.5 to 2.5 h were simulated in an in vitro model, and the PAE was determined by an enzymatic inactivation method at different time points, i.e., when the tobramycin concentrations were 20x, 5x, and 1x the MIC. At the time point during therapy when the tobramycin concentrations had declined to 1x the MIC, at a tobramycin half-life of 0.5 h, the times of the PAEs were approximately 0.7 and 1.7 h for P. aeruginosa and S. aureus, respectively, and the PAE disappeared completely at half-lives corresponding to those found in humans (i.e., 2 to 2.5 h). The PAE itself cannot be fully explained by the presence of free intrabacterial tobramycin or the emergence of resistant subpopulations. The explanation for the disappearance of the PAE during the dosing interval may therefore be explained by the repair of sublethal damage. Since the standard method of determining the PAE in animal models is somewhat different from the method used for measurement of the PAE in vitro, the conditions under which the PAE is measured in vivo were also simulated in the in vitro model. This resulted in PAEs longer than those found by the standard method of obtaining in vitro PAE measurements. We conclude that the PAE of tobramycin, as determined by conventional in vitro methods, has virtually no clinical importance. PAEs determined in vivo may have some clinical relevance, but they are probably primarily caused by sub-MIC effects.
Authors:
J G den Hollander; K Fuursted; H A Verbrugh; J W Mouton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Antimicrobial agents and chemotherapy     Volume:  42     ISSN:  0066-4804     ISO Abbreviation:  Antimicrob. Agents Chemother.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-06-22     Completed Date:  1998-06-22     Revised Date:  2013-06-11    
Medline Journal Info:
Nlm Unique ID:  0315061     Medline TA:  Antimicrob Agents Chemother     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  749-54     Citation Subset:  IM    
Affiliation:
Department of Medical Microbiology and Infectious Diseases, University Hospital Rotterdam, Dijkzigt, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Animals
Anti-Bacterial Agents / administration & dosage,  pharmacokinetics,  pharmacology*
Area Under Curve
Culture Media
Drug Resistance, Microbial
Half-Life
Kidney Diseases / metabolism,  microbiology
Mice
Microbial Sensitivity Tests
Models, Biological
Pseudomonas aeruginosa / drug effects
Staphylococcus aureus / drug effects
Tobramycin / administration & dosage,  pharmacokinetics,  pharmacology*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Culture Media; 32986-56-4/Tobramycin
Comments/Corrections

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