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Antimicrobial Agents and Chemotherapy, November 2001, p. 3029-3036, Vol. 45, No. 11
Instituto Nacional de Câncer,
Coordenação de Pesquisa,1 and
Unidade de Farmacologia Clínica, Santa Casa da
Misericórdia,2 Rio de Janeiro, Brazil
Received 15 December 2000/Returned for modification 29 May
2001/Accepted 12 August 2001
Amoxicillin plasma concentrations (n = 1,152)
obtained from 48 healthy subjects in two bioequivalence
studies were used to develop limited-sampling strategy (LSS) models for
estimating the area under the concentration-time curve (AUC), the
maximum concentration of drug in plasma
(Cmax), and the time interval of
concentration above MIC susceptibility breakpoints in plasma (T>MIC).
Each subject received 500-mg amoxicillin, as reference and test
capsules or suspensions, and plasma concentrations were measured by a
validated microbiological assay. Linear regression analysis and a
"jack-knife" procedure revealed that three-point LSS models
accurately estimated (R2, 0.92; precision,
<5.8%) the AUC from 0 h to infinity (AUC0-
0066-4804/01/$04.00+0 DOI: 10.1128/AAC.45.11.3029-3036.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Development and Validation of Limited-Sampling
Strategies for Predicting Amoxicillin Pharmacokinetic and
Pharmacodynamic Parameters
) of amoxicillin for the four formulations tested. Validation tests indicated that a three-point LSS model (1, 2, and 5 h) developed for the reference capsule formulation predicts the following accurately (R2, 0.94 to 0.99): (i) the individual
AUC0-
for the test capsule formulation in the same
subjects, (ii) the individual AUC0-
for both
reference and test suspensions in 24 other subjects, and (iii) the
average AUC0-
following single oral doses (250 to
1,000 mg) of various amoxicillin formulations in 11 previously
published studies. A linear regression equation was derived, using the
same sampling time points of the LSS model for the
AUC0-
, but using different coefficients and
intercept, for estimating Cmax.
Bioequivalence assessments based on LSS-derived AUC0-
's and Cmax's
provided results similar to those obtained using the original values
for these parameters. Finally, two-point LSS models
(R2 = 0.86 to 0.95) were developed for
T>MICs of 0.25 or 2.0 µg/ml, which are representative of
microorganisms susceptible and resistant to amoxicillin.
*
Corresponding author. Mailing address: Instituto
Nacional de Câncer, Coordenação de Pesquisa,
Praça da Cruz Vermelha 23/5°, Rio de Janeiro, RJ
20130-230, Brazil. Phone: 5521 2506-6275. Fax: 5521 2506-6376. E-mail:
kurtz{at}inca.org.br.
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