Pharmacodynamics of trovafloxacin in a mouse model of cephalosporin-resistant Streptococcus pneumoniae pneumonia.

Abstract

Trovafloxacin is a potentially useful agent for treatment of infections caused by cephalosporin-resistant Streptococcus pneumoniae. We studied the effectiveness of trovafloxacin therapy and examined the correlation between pharmacodynamic indices in serum and lung, and bacterial killing. Immunocompetent Balb/c mice were infected by intranasal inoculation of a cephalosporin-resistant S. pneumoniae isolate (MIC of ceftriaxone and trovafloxacin 2 and 0.06 mg/L, respectively). Trovafloxacin 10-30 mg/kg/day in one or three divided doses was started 15 h after infection. Serum and lung drug concentrations were measured at multiple time points for 24 h. Serum concentrations peaked at 30-60 min and lung concentrations approximately 30 min later. The serum T1/2 was approximately 9 h and lung T1/2 varied from 5 to 9 h. Lung AUC and Cmax values were 2-3 times greater than those in serum. At the start of therapy lung bacterial concentrations were 8.4 +/- 0.3 log10 cfu/mL and 24 h later had decreased by 3.5 +/- 0.2, 4.0 +/- 0.2, 0.8 +/- 0.3 and 1.0 +/- 1.2 log10 cfu/mL with 30 mg/kg x 1, 10 mg/kg x 3, 10 mg/kg x 1 and 3.3 mg/kg x 3 regimens, respectively. Although the larger dosages were more effective (P < 0.001) the differences between divided and single dosage regimens were not significant. Trovafloxacin serum AUC/MIC ratio correlated best with bacterial killing in the lungs over 24 h. Trovafloxacin is likely to be useful in the treatment of cephalosporin-resistant S. pneumoniae pneumonia.

• Authors: W Ng, I Lutsar, L Wubbel, F Ghaffar, H Jafri, G H McCracken, I R Friedland
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 43 Issue 6 Pg. 811-6 (Jun 1999) ISSN: 0305-7453 [Print] England
• PMID: 10404320 (Publication Type: Journal Article)

Chemical References

• Anti-Infective Agents
• Cephalosporins
• Fluoroquinolones
• Naphthyridines
• trovafloxacin

Topics

• Analysis of Variance
• Animals
• Anti-Infective Agents (blood, pharmacokinetics, pharmacology, therapeutic use)
• Cephalosporin Resistance (physiology)
• Cephalosporins
• Disease Models, Animal
• Female
• Fluoroquinolones
• Lung (metabolism, microbiology)
• Mice
• Mice, Inbred BALB C
• Microbial Sensitivity Tests
• Naphthyridines (blood, pharmacokinetics, pharmacology, therapeutic use)
• Pneumonia, Pneumococcal (blood, drug therapy)
• Streptococcus pneumoniae (drug effects)