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中国临床药理学与治疗学 ›› 2024, Vol. 29 ›› Issue (1): 52-60.doi: 10.12092/j.issn.1009-2501.2024.01.005

• 基础研究 • 上一篇    下一篇

头孢吡肟/阿维巴坦M-H肉汤中浓度测定方法学建立及在体外动态PK/PD模型中的应用

颜冰倩1,2,郭思维2,3,李  尤1,2,田淼梅1,2, 徐  兵2,3,蒋  蓉2,3,李  昕2,3   

  1. 1湖南中医药大学,长沙  410208,湖南;2长沙市第三医院,长沙  410015,湖南;3长沙市抗菌药物临床应用研究所,长沙  410015,湖南
  • 收稿日期:2023-07-05 修回日期:2023-08-14 出版日期:2024-01-26 发布日期:2024-01-15
  • 通讯作者: 李昕,女,博士,主任药师,硕士生导师,研究方向:抗感染药物的临床药理学、新药临床研究与评价。
  • 作者简介:颜冰倩,女,硕士研究生,研究方向:抗感染药物PK/PD研究。 E-mail: 993529010@qq.com
  • 基金资助:
    抗耐药微生物药物湖南省重点实验室项目(2023TP1013);湖南省临床医疗技术创新引导项目(2021SK53002)

Development and validation of a method for quantitation of cefepime/avibactam in M-H broth: application to antibacterial activity using in vitro PK/PD Model

YAN Bingqian1,2, GUO Siwei2,3, LI You1,2, TIAN Miaomei1,2, XU Bing2,3, JIANG Rong2,3, LI Xin2,3   

  1. 1 Hunan University of Chinese Medicine, Changsha 410208, Hunan, China; 2 The Third Hospital of Changsha, Changsha 410015, Hunan, China; 3 Changsha Institute of Clinical Application of Antibiotics, Changsha 410015, Hunan, China
  • Received:2023-07-05 Revised:2023-08-14 Online:2024-01-26 Published:2024-01-15

摘要:

目的:建立头孢吡肟和阿维巴坦在Mueller-Hinton(M-H)肉汤中浓度测定方法,并于头孢吡肟/阿维巴坦体外动态药代动力学/药效学(pharmacokinetic/pharmacodynamic,PK/PD)模型中进行初步应用。方法:采用高效液相色谱法(HPLC)对M-H肉汤中头孢吡肟进行测定;采用液质联用法(LC-MS/MS)对M-H肉汤中阿维巴坦进行测定。建立头孢吡肟/阿维巴坦2.5 g q8 h给药方案下体外动态PK/PD感染模型,进行头孢吡肟/阿维巴坦抗碳青霉烯类耐药肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)抗菌作用研究。结果:头孢吡肟和阿维巴坦在0.5~120 μg/mL和0.1~25 μg/mL线性关系良好(r=0.999),定量下限浓度为0.5、0.1 μg/mL,肉汤培养基中头孢吡肟和阿维巴坦的的提取回收率分别为88.0%~101.7%和90.9%~95.2%。日内、日间RSD均小于5.2% 。在体外PK/PD模型中,头孢吡肟和阿维巴坦具有良好的拟合度,实测浓度在理论浓度的±20%范围内。对于MIC=8 μg/mL和MIC=16 μg/mL的CRKP,头孢吡肟阿维巴坦2.5 g q8 h的给药方案在24 h时菌落分别下降2.783 Log10 CFU/mL、1.325 Log10 CFU/mL。结论:本研究建立的头孢吡肟及阿维巴坦在肉汤中浓度测定方法灵敏度高、稳定性好。体外动态PK/PD模型显示头孢吡肟阿维巴坦常规给药下对MIC≤8 μg/mL的CRKP具有较好的抗菌活性。

关键词: 头孢吡肟, 阿维巴坦, HPLC, LC-MS/MS, 体外动态PK/PD模型

Abstract:

AIM: To establish a method for quantitation of cefepime and avibactam in M-H broth, and applicated in the in vitro dynamic PK/PD model. METHODS: The cefepime was also determined using the high-performance liquid chromatography method (HPLC), the avibactam was also determined using the liquid chromatography-mass spectrometry (LC-MS/MS), an in vitro dynamic?PK/PD?model was established to study the?PK/PD?relationship of cefepime/avibactam against carbapenem resistant Klebsiella pneumoniae (CRKP). RESULTS: The linear ranges of cefepime and avibactam were good at (0.5-20) and (0.1-25) μg/mL (r=0.999), and the lower limit concentrations were 0.5 and 0.1 μg/mL. The extraction recoveries of cefepime and avibactam in M-H broth were 88.0%-101.7% and 90.9%-95.2%, the relative standard deviation of intra-day precision and inter-day precision were less than 5.2%. The concentration-time curves were well simulated by the PK/PD model. All observed concentrations in each experiment were in the range of 20% of the targeted values. For the CRKP of MIC=8 μg/mL and MIC=16 μg/mL, the colony decreased to 2.783Log10 CFU/mL and 1.325Log10 CFU/mL at the cefepime/avibactam 2.5 g q8 h administration after 24 h. CONCLUSION: The determination method of cefepime and avibactam in broth established in this study has high sensitivity and good stability. For the CRKP with MIC≤8 μg/mL,cefepime/avibactam showed that good anti-CRKP activity under routine administration in vitro dynamic PK/PD model.

Key words: cefepime, avibactam, HPLC, LC-MS/MS,  in vitro dynamic PK/PD model

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