EVALUATION OF EFFICACY OF ORAL QUINOLONE AGAINST <I>Streptococcus pneumoniae</I> AND <I>Haemophilus influenzae</I> WITH THE USE OF MONTE CARLO SIMULATION

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  • 肺炎球菌およびインフルエンザ菌に対する経口キノロン薬のMonte Carlo Simulationを用いた有効性評価
  • ハイエン キュウキン オヨビ インフルエンザキン ニ タイスル ケイコウ キノロンヤク ノ Monte Carlo Simulation オ モチイタ ユウコウセイ ヒョウカ

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Abstract

We investigated the efficacies of various administration methods for levofloxacin (LVFX) and tosufloxacin (TFLX) against 161 isolates of Streptococcus pneumoniae and 309 isolates of Haemophilus influenzae isolated in Gifu prefecture, using Monte Carlo simulation. The pharmacokinetic parameters of the fluoroquinolones were calculated from changes in blood concentration in healthy adults. Monte Carlo simulation was performed for 1,000 times to determine the AUC/MIC target attainment rates for various administration methods for fluoroquinolones (LVFX: 100mg×3,200mg×2,500mg×1, TFLX: 150mg×3,300mg×2) with Crystal Ball 7. For S. pneumoniae, target attainment rates of AUC/MIC; 30 were 47.18%, 75.54%, 89.16%, 93.63% and 98.63% for LVFX 100mg×3, LVFX 200mg×2, LVFX 500mg×1, TFLX 150mg×3 and TFLX 300mg×2, respectively. For H. influenzae, target attainment rates of AUC/MIC; 125 were 99.20%, 99.05%, 99.54%, 99.66% and 100% for LVFX 100mg×3, LVFX 200mg×2, LVFX 500mg×1, TFLX 150mg×3 and TFLX 300mg×2, respectively. These results suggest that administration methods might have a large impact on the efficacy of treatment with oral fluoroquinolones, and to determine administration method based on PK/PD would be important in clinical practices.

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