Abstract
A dose-decreasing immunocompetent sepsis mouse model was used to evaluate the in vivo effect of levofloxacin, moxifloxacin and gemifloxacin, using a ciprofloxacin/levofloxacin susceptible serotype 6B strain (ciprofloxacin MIC: 1 mg/l) and two resistant serotype 14 and 19F strains with gyrA and parC point mutations (ciprofloxacin MICs of 32 and 64 mg/l, respectively). Significant higher in vivo activity was found for moxifloxacin and gemifloxacin than for levofloxacin against strains 1 and 2, and for gemifloxacin versus moxifloxacin or levofloxacin against strain 3. Gemifloxacin treatment resulted in 100% survival against strains 1 and 2(AUC0-24 h/MIC of 30 and 62) but against strain 3, survival was 60-80% (AUC0-24 h/MIC of 93). Similar AUC0-24 h/MIC values produced different therapeutic results suggesting that in vitro parameters other than the MIC could influence efficacy predictions based on in vitro susceptibility tests (MICs) or pharmacodynamic parameters (AUC0-24 h/MIC).
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Animals
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Anti-Infective Agents / pharmacology
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Anti-Infective Agents / therapeutic use*
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Aza Compounds / pharmacology
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Aza Compounds / therapeutic use
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Ciprofloxacin / pharmacology
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DNA Gyrase / genetics*
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DNA Topoisomerase IV / genetics*
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Disease Models, Animal
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Drug Resistance, Bacterial
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Female
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Fluoroquinolones / pharmacology
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Fluoroquinolones / therapeutic use*
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Gemifloxacin
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Levofloxacin
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Mice
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Microbial Sensitivity Tests
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Moxifloxacin
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Naphthyridines / pharmacology
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Naphthyridines / therapeutic use
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Ofloxacin / pharmacology
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Ofloxacin / therapeutic use
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Pneumococcal Infections / drug therapy
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Pneumococcal Infections / microbiology
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Pneumococcal Infections / mortality
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Point Mutation
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Quinolines / pharmacology
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Quinolines / therapeutic use
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Sepsis / drug therapy*
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Sepsis / microbiology
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Sepsis / mortality
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Streptococcus pneumoniae / drug effects*
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Streptococcus pneumoniae / enzymology
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Streptococcus pneumoniae / genetics
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Treatment Outcome
Substances
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Anti-Infective Agents
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Aza Compounds
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Fluoroquinolones
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Naphthyridines
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Quinolines
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Ciprofloxacin
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Levofloxacin
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Ofloxacin
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DNA Topoisomerase IV
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DNA Gyrase
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Gemifloxacin
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Moxifloxacin