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      Eficacia de florfenicol para el tratamiento de pioderma por Staphylococcus intermedius en perros Translated title: Efficacy of florfenicol for the treatment of Staphylococcus intermedius pyoderma in dogs

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          Abstract

          RESUMEN El objetivo del presente trabajo fue evaluar el efecto del tratamiento con florfenicol en las dosis de 10 y 20 mg/kg administrados por vía IM, en el tratamiento de la pioderma canina por Staphylococcus intermedius, utilizando el modelamiento farmacocinético/ farmacodinámico (PK/PD). Se hizo una simulación de Monte Carlo de los parámetros farmacocinéticos y farmacodinámicos y luego se realizó el análisis PK/PD para determinar las tasas de eficacia en el tratamiento de la infección bacteriana, según la concentración inhibitoria mínima (CIM) del S.intermedius, utilizando el intervalo entre 0.25 y 2 µg/ml. Las probabilidades de obtener el índice de erradicación bacteriológica con la dosis de 10 mg/kg fue de 97, 77, 7 y 1%, y con la dosis de 20 mg/kg fue de 95, 87, 61 y 7%, según las CIMs bacterianas de 0.25, 0.5, 1 y 2 µg/ml, respectivamente. La probabilidad de obtener la cura bacteriológica después del tratamiento con la dosis de 10 mg/kg disminuyó de forma significativa para infecciones causadas por microrganismos con CIM superior a 0.5 µg/ml (p<0.01), mientras que para la dosis de 20 mg/kg fue con CIM mayor de 1 µg/ml (p<0.01). El resultado evidencia la necesidad de incorporar en el protocolo terapéutico el aislamiento bacteriológico, la determinación de la CIM y la optimización de dosis terapéuticas basadas en la susceptibilidad bacteriana a fin de evitar fallas en terapéuticas y, consecuentemente, el incremento del desarrollo de resistencia microbiana.

          Translated abstract

          ABSTRACT The aim of this study was to evaluate the effect of florfenicol treatment at doses of 10 and 20 mg/kg administered IM, in the treatment of canine pyoderma due to Staphylococcus intermedius, using pharmacokinetic/pharmacodynamic modelling (PK/ PD). A Monte Carlo simulation of the pharmacokinetic and pharmacodynamic parameters was performed, followed by a PK/PD modelling to determine the efficacy rates in the treatment of bacterial infection, according to the minimum inhibitory concentration (MIC) of S. intermedius, using the range between 0.25 and 2 µg/ml. The probabilities of obtaining the bacteriological eradication index with the 10 mg/kg dose were 97, 77, 7 and 1%, and with the 20 mg/kg dose it was 95, 87, 61 and 7%, according to bacterial MICs of 0.25, 0.5, 1 and 2 µg/ml, respectively. The probability of obtaining a bacteriological cure after treatment with the 10 mg/kg dose decreased significantly for infections caused by microorganisms with MICs higher than 0.5 µg/ml (p<0.01), while for the 20 mg/kg dose kg was with MIC greater than 1 µg/ml (p<0.01). The results show the need to incorporate bacteriological isolation, the determination of MIC and the optimization of therapeutic doses based on bacterial susceptibility in the therapeutic protocol in order to avoid therapeutic failures and, consequently, the increase in the development of microbial resistance.

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          Applying pharmacokinetic/pharmacodynamic principles in critically ill patients: optimizing efficacy and reducing resistance development.

          The recent surge in multidrug-resistant pathogens combined with the diminishing antibiotic pipeline has created a growing need to optimize the use of our existing antibiotic armamentarium, particularly in the management of intensive care unit (ICU) patients. Optimal and timely pharmacokinetic/pharmacodynamic (PK/PD) target attainment has been associated with an increased likelihood of clinical and microbiological success in critically ill patients. Emerging data, mostly from in vitro and in vivo studies, suggest that optimization of antibiotic therapy should not only aim to maximize clinical outcomes but also to include the suppression of resistance. The development of antibiotic dosing regimens that adheres to the PK/PD principles may prolong the clinical lifespan of our existing antibiotics by minimizing the emergence of resistance. This article summarizes the relevance of PK/PD characteristics of different antibiotic classes on the development of antibiotic resistance. On the basis of the available data, we propose dosing recommendations that can be adopted in the clinical setting, to maximize therapeutic success and limit the emergence of resistance in the ICU.
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            The role of infection models and PK/PD modelling for optimising care of critically ill patients with severe infections

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              Comprehensive Guidance for Antibiotic Dosing in Obese Adults

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                Author and article information

                Journal
                rivep
                Revista de Investigaciones Veterinarias del Perú
                Rev. investig. vet. Perú
                Universidad Nacional Mayor de San Marcos. Facultad de Medicina Veterinaria (Lima, , Peru )
                1609-9117
                January 2021
                : 32
                : 1
                : e17678
                Affiliations
                [2] Umuarama,Maringá Paraná orgnameUniversidade Estadual de Maringá orgdiv1Departamento de Medicina Veterinaria orgdiv2Laboratorio de Microbiologia Brazil
                [1] Lavras Minas Gerais orgnameUniversidade Federal de Lavras orgdiv1Departamento de Medicina Veterinaria orgdiv2Laboratorio de Fisiología y Farmacología Brazil
                Article
                S1609-91172021000100022 S1609-9117(21)03200100022
                10.15381/rivep.v32i1.17678
                b0c5e2a8-87fd-4c85-9f1e-147b220c15d6

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 April 2020
                : 14 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 0
                Product

                SciELO Peru

                Categories
                Artículos primarios

                antibiotic therapy,modelamiento PK/PD,medicina individualizada,infección bacteriana,antibioticoterapia,PK/PD modelling,individualized medicine,bacterial infection

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