Once versus thrice daily tobramycin alone and in combination with ceftazidime, ciprofloxacin and imipenem in an in vitro pharmacodynamic model

Chemotherapy. 1998 Jan-Feb;44(1):1-6. doi: 10.1159/000007083.

Abstract

The purpose of this study was to compare once daily (To24) and thrice daily (To8) tobramycin dosing regimens alone and in combination with ceftazidime, ciprofloxacin and imipenem against a clinical and ATCC strain of Pseudomonas aeruginosa. A one-compartment in vitro pharmacodynamic model was used to simulate bacteremic infection. Pharmacodynamic parameters, including rate of bacterial kill following the first dose or time to achieve a 99.9% reduction in bacterial counts (T99.9%), extent of bacterial kill with subsequent doses and bacterial count at 24 h were characterized for each regimen. Compared to To8 alone, the combination regimens had a shorter T99.9% (p = 0.045) and greater extent of bacterial kill following the first dose (p = 0.045). Compared to To24 alone, the combination regimens demonstrated similar rates (p = 0.067) and extents of bacterial kill following the first dose (p = 0.32), however, produced lower bacterial counts at 24 h (p = 0.045). The various combination regimens appeared equally effective considering rate and extent of bacterial kill following the first dose and residual inocula at 24 h. Ciprofloxacin-containing regimens demonstrated the most bacterial kill with subsequent doses, however, bacterial counts at 24 h were similar to those of other combination regimens.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacokinetics*
  • Anti-Infective Agents / administration & dosage*
  • Anti-Infective Agents / pharmacokinetics*
  • Body Fluid Compartments
  • Ceftazidime / administration & dosage*
  • Ceftazidime / pharmacokinetics*
  • Cephalosporins / administration & dosage*
  • Cephalosporins / pharmacokinetics*
  • Ciprofloxacin / administration & dosage*
  • Ciprofloxacin / pharmacokinetics*
  • Drug Administration Schedule
  • Drug Therapy, Combination / administration & dosage*
  • Drug Therapy, Combination / pharmacokinetics*
  • Humans
  • Imipenem / administration & dosage*
  • Imipenem / pharmacokinetics*
  • Microbial Sensitivity Tests
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / metabolism*
  • Pseudomonas aeruginosa / drug effects*
  • Thienamycins / administration & dosage*
  • Thienamycins / pharmacokinetics*
  • Tobramycin / administration & dosage*
  • Tobramycin / pharmacokinetics*

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Cephalosporins
  • Thienamycins
  • Ciprofloxacin
  • Imipenem
  • Ceftazidime
  • Tobramycin