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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2024, Vol. 29 ›› Issue (1): 52-60.doi: 10.12092/j.issn.1009-2501.2024.01.005

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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

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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