Prediction of higher ceftazidime-avibactam concentrations in the human renal interstitium compared with unbound plasma using a minimal physiologically based pharmacokinetic model developed in rats and pigs through microdialysis.

IF 4.1 2区 医学 Q2 MICROBIOLOGY
Antimicrobial Agents and Chemotherapy Pub Date : 2025-03-05 Epub Date: 2025-02-06 DOI:10.1128/aac.01518-24
Maxime Vallée, Vincent Aranzana-Climent, Jérémy Moreau, Isabelle Lamarche, Théo Fontanier, Céline Barc, Nathalie Kasal-Hoc, Céline Debiais-Delpech, Hélène Mirfendereski, Jérémy Pezant, Anne Pinard, Jonathan Clarhaut, William Couet, France Cazenave-Roblot, Sandrine Marchand
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引用次数: 0

Abstract

Last resort antibiotics, like ceftazidime-avibactam (CZA), were used to treat urinary tract infections caused by multidrug-resistant bacteria. However, no data on tissue distribution were available. Our aim was to describe the in vivo kidney distribution of CZA in healthy rats and pigs using a physiologically based pharmacokinetic model (PBPK). Microdialysis probes were inserted into the blood, muscle, and kidney of both species. The experiment started with a retrodialysis by drug period. An i.v. single dose of CZA was administered. Samples were collected for 3 h in rats and 7 h in pigs. A PBPK model was developed to describe tissue and blood CZA pharmacokinetics in animals and to predict human concentrations. The PBPK model adequately described CZA rat and pig data in each tissue and blood. In both species, the concentration profiles of CZA in muscle and blood were almost superimposed, with muscle-to-plasma area under the curve (AUC) ratios close to one. However, kidney CZA concentrations were higher than those in blood, as indicated by kidney-to-plasma AUC ratios exceeding one (respectively 2.27 in rats and 2.63 in pigs for ceftazidime [CAZ]; 2.7 in rats and 4.5 in pigs for avibacam [AVI]). Prediction of human concentrations led to same observations. This study demonstrated an excellent penetration of CZA into the renal parenchyma of rats and pigs. Our PBPK model adequately described the data, and AUCs were higher in the renal cortex interstitium compared with unbound plasma. Our data suggested that the joint PK/PD target for CZA in humans could be attained with reduced CZA doses.

通过微透析在大鼠和猪身上建立的最小生理药代动力学模型,预测人肾间质中头孢他啶-阿维巴坦浓度高于未结合血浆。
最后的抗生素,如头孢他啶-阿维巴坦(CZA),被用于治疗多重耐药细菌引起的尿路感染。然而,没有关于组织分布的数据。我们的目的是利用基于生理的药代动力学模型(PBPK)来描述CZA在健康大鼠和猪体内的肾脏分布。将微透析探针插入两种动物的血液、肌肉和肾脏。实验开始于药物后透析期。给予单剂量CZA静脉注射。大鼠标本采集3 h,猪标本采集7 h。建立了PBPK模型来描述动物组织和血液中CZA的药代动力学,并预测人体浓度。PBPK模型充分描述了CZA大鼠和猪各组织和血液中的数据。在这两个物种中,CZA在肌肉和血液中的浓度曲线几乎重合,肌肉与血浆曲线下面积(AUC)比接近于1。然而,肾CZA浓度高于血中CZA浓度,表现为头孢他啶(CAZ)的肾与血浆AUC比值超过1(大鼠为2.27,猪为2.63);阿维巴康在大鼠中为2.7,在猪中为4.5。对人类浓度的预测也得出了同样的结论。本研究表明,CZA对大鼠和猪的肾实质具有良好的渗透作用。我们的PBPK模型充分描述了这些数据,与未结合的血浆相比,肾皮质间质中的auc更高。我们的数据表明,减少CZA剂量可以达到人类CZA的联合PK/PD目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
10.00
自引率
8.20%
发文量
762
审稿时长
3 months
期刊介绍: Antimicrobial Agents and Chemotherapy (AAC) features interdisciplinary studies that build our understanding of the underlying mechanisms and therapeutic applications of antimicrobial and antiparasitic agents and chemotherapy.
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