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High Doses of Levofloxacin vs Moxifloxacin Against Staphylococcal Experimental Foreign-Body Infection: The Effect of Higher MIC-related Pharmacokinetic Parameters on Efficacy

High Doses of Levofloxacin vs Moxifloxacin Against Staphylococcal Experimental Foreign-Body Infection: The Effect of Higher MIC-related Pharmacokinetic Parameters on Efficacy

Oscar Murillo, M Eugenia Pachón, Gorane Euba, Ricard Verdaguer, Fe Tubau, Carmen Cabellos, Javier Cabo, Francesc Gudiol, Javier Ariza

J Infect. 2009 Mar;58(3):220-6.

PMID: 19217166

Abstract:

Objectives:
Since levofloxacin at high doses was the best therapy in staphylococcal tissue-cage model of foreign-body infection, we hypothesized that moxifloxacin with higher ratio of area under the concentration-time curve to the MIC (AUC/MIC) would provide better results.
Methods:
MICs, MBCs, MPCs (mutant prevention concentration) and 24h kill-curves were determined in the log and stationary phases. Using the aforementioned model, we tested the efficacy of levofloxacin 100mg/kg/d, moxifloxacin 40mg/kg/d and moxifloxacin 80mg/kg/d; they were equivalent to human levels for 1000mg/d, 400mg/d and 800mg/d, respectively. We screened for the appearance of resistant strains.
Results:
MICs and MBCs in logarithmic and stationary phases and MPCs of levofloxacin were 0.5, 1 and 4, 0.8microg/ml, respectively, and those of moxifloxacin 0.12, 0.25 and 2, 0.25microg/ml. AUC/MIC were 234 (levofloxacin), 431 (moxifloxacin 40) and 568 (moxifloxacin 80). Bacterial counts decreases in tissue-cage fluids (means of logCFU/ml) were -1.81 (n=25), -1.31 (23), and -1.46 (20), respectively; for controls it was 0.24 (22). All groups were better than controls (p<0.05); no differences between them existed.
Conclusions:
Moxifloxacin with higher AUC/MIC ratio did not improve the efficacy of high doses of levofloxacin.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP1029364779	Moxifloxacin Related Compound D		1029364-77-9	Price

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