Document Detail


Mechanism-based pharmacokinetic-pharmacodynamic models of in vitro fungistatic and fungicidal effects against Candida albicans.
MedLine Citation:
PMID:  18180347     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mechanism-based pharmacokinetic-pharmacodynamic (PK-PD) models describing the fungistatic activity of fluconazole and the fungicidal activity of caspofungin were developed using dynamic in vitro models. Antifungal-drug pharmacokinetics was simulated in vitro, assuming a one-compartment model with an elimination half-life of 3 h and using a wide (1 to 10,000) range of initial concentrations. The number of CFUs over time was determined for up to 31 h and used for PK-PD modeling. A model incorporating first-order natural growth and natural death, plus a maximum number of viable Candida cells, was used to characterize Candida growth in the absence of a drug. Fluconazole was considered to inhibit Candida growth and caspofungin to stimulate Candida death according to an Emax pharmacodynamic model. The data were analyzed with Nonmem, using a population approach. A good fit of the data was obtained with satisfactory estimates of PK-PD parameters, especially with drug concentrations producing 50% of the maximal effect: 50% inhibitory concentrations for fluconazole growth inhibition and 50% effective concentrations for caspofungin death stimulation. In conclusion, mechanistic PK-PD models were successfully developed to describe, respectively, the fungistatic and fungicidal activities of fluconazole and caspofungin in vitro. These models provide much better information on the drug effects over time than the traditional PK-PD index based on MICs. However, they need to be further characterized.
Authors:
Nicolas Venisse; Nicolas Grégoire; Manuella Marliat; William Couet
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Publication Detail:
Type:  Journal Article     Date:  2008-01-07
Journal Detail:
Title:  Antimicrobial agents and chemotherapy     Volume:  52     ISSN:  0066-4804     ISO Abbreviation:  Antimicrob. Agents Chemother.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-26     Completed Date:  2008-09-02     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0315061     Medline TA:  Antimicrob Agents Chemother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  937-43     Citation Subset:  IM    
Affiliation:
Inserm ERI-23, 40 avenue du Recteur Pineau, 86022 Poitiers, France.
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents* / pharmacokinetics,  pharmacology,  therapeutic use
Candida albicans* / drug effects,  growth & development
Candidiasis* / drug therapy,  microbiology
Colony Count, Microbial
Dose-Response Relationship, Drug
Drug Resistance, Fungal
Echinocandins* / pharmacokinetics,  pharmacology,  therapeutic use
Fluconazole* / pharmacokinetics,  pharmacology,  therapeutic use
Humans
Microbial Sensitivity Tests
Models, Biological*
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Echinocandins; 0/caspofungin; 86386-73-4/Fluconazole
Comments/Corrections

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