Monte Carlo simulation for evaluation of the efficacy of linezolid, tigecycline and vancomycin again

• 作 者: LiangBeibei;WangRui;BaiNan;CaiYun;
• 机 构: Department of Clinical Pharmacology, General Hospital of Chinese People's Liberation Army,28 Fuxing
• 出 处: 2011年中国药学大会暨第11届中国药师周
• 发表日期: 2011年期

To compare the pharmacodynamic potency of linezolid, tigecycline and vancomycin against methicillin-resistant Staphylococcus aureus (MRSA) isolates collected in China. METHODS: MIC determinations were performed for 250 MRSA isolates. Pharmacodynamic exposure, measured as ratio of steady-state total drug area under the curve to MIC (AUC/MIC), was modelled via a 10000-subject Monte Carlo simulation. Pharmacodynamic targets included an AUC.MIC >82.9 for linezolid , AUC. MIC >17.9 for tigecycline and AUC. MIC >400 for vancomycin. RESULTS: The cumulative fraction of response (CFR) against all MRSA isolates were 88％ and 85％ for linezolid and tigecycline. The CFRs of vancomycin in young population and vancomycin in elderly population were 87％, 98％, respectively. Standard regimens of linezolid, tigecycline and vancomycin performed poorly(<20％) against MRSA isolates with MIC.4 mg.L, 0.5 mg.L and 1.5 mg.L, respectively. CONCLUSIONS: Linezolid, tigecycline and vancomycin are likely to be effective agents against MRSA isolates in China. However, their ability to achieve high bactericidal or bacteriostatic pharmacodynamic exposure will be dependent on the bacterial susceptibility.