Universität zu Köln

Taubert, Max ORCID: 0000-0001-8925-7782, Lueckermann, Mark, Vente, Andreas, Dalhoff, Axel and Fuhr, Uwe (2018). Population Pharmacokinetics of Finafloxacin in Healthy Volunteers and Patients with Complicated Urinary Tract Infections. Antimicrob. Agents Chemother., 62 (4). WASHINGTON: AMER SOC MICROBIOLOGY. ISSN 1098-6596

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Abstract

Finafloxacin is a novel fluoroquinolone with increased antibacterial activity at acidic pH and reduced susceptibility to several resistance mechanisms. A phase II study revealed a good efficacy/safety profile in patients with complicated urinary tract infections (cUTIs), while the pharmacokinetics was characterized by highly variable concentration-versus-time profiles, suggesting the need for an elaborated pharmacokinetic model. Data from three clinical trials were evaluated: 127 healthy volunteers were dosed orally (n = 77) or intravenously (n = 50), and 139 patients with cUTI received finafloxacin intravenously. Plasma (2,824 samples from volunteers and 414 samples from patients) and urine (496 samples from volunteers and 135 samples patients) concentrations were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). NONMEM was used to build a population pharmacokinetic model, and pharmacokinetic/pharmacodynamic relationships were investigated via simulations and logistic regression. A two-compartment model with first-order elimination described the data best (central volume of distribution [V-c] and peripheral volume of distribution [V-p] of 47 liters [20%] and 43 liters [67%], respectively, and elimination clearance and intercompartmental clearance of 21 liters/h [54%] and 2.8 liters/h [57%], respectively [median bootstrap estimates {coefficients of variation}]). V-c increased with body surface area, and clearance was reduced in patients (-29%). Oral absorption was described best by parallel first-and zero-order processes (bioavailability of 75%). No pharmacodynamic surrogate parameter of clinical/microbiological outcome could be identified, which depended exclusively on the MIC of the causative pathogens. Despite the interindividual variability, the present data set does not support covariate-based dose adjustments. Based on the favorable safety and efficacy data, the clinical relevance of the observed variability appears to be limited.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Taubert, Max UNSPECIFIED orcid.org/0000-0001-8925-7782 UNSPECIFIED Lueckermann, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED Vente, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Dalhoff, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuhr, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-191714
DOI:	10.1128/AAC.02328-17
Journal or Publication Title:	Antimicrob. Agents Chemother.
Volume:	62
Number:	4
Date:	2018
Publisher:	AMER SOC MICROBIOLOGY
Place of Publication:	WASHINGTON
ISSN:	1098-6596
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ECONOMIC-EVALUATION; INVITRO ACTIVITY; FLUOROQUINOLONE; CIPROFLOXACIN; THERAPY; PH; PHARMACODYNAMICS; ACETAMINOPHEN; COMPLETENESS; RESISTANCE Multiple languages Microbiology; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19171