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. 1989 May;33(5):693–699. doi: 10.1128/aac.33.5.693

Simulation of human serum pharmacokinetics of ticarcillin-clavulanic acid and ceftazidime in rabbits, and efficacy against experimental Klebsiella pneumoniae meningitis.

L Mizen 1, G Woodnutt 1, I Kernutt 1, E J Catherall 1
PMCID: PMC172516  PMID: 2665641

Abstract

The penetration into cerebrospinal fluid (CSF) and efficacy of ticarcillin-clavulanic acid, ticarcillin alone, and ceftazidime were compared in rabbits with experimentally induced Klebsiella pneumoniae meningitis. The compounds were administered to simulate in rabbit plasma the concentration-versus-time curves observed in humans after 30-min infusions of Timentin (3 g of ticarcillin plus 100 mg of clavulanic acid), ticarcillin (3 g), and ceftazidime (2 g). Single- and multiple-dosing schedules were used. The penetrations of clavulanic acid into CSF (expressed as [area under the concentration-time curve for CSF/area under the curve for plasma] x 100) after the two dosing schedules were 28 and 24.5%, similar to that for ceftazidime (21%; multiple-dosing only) and greater than those for ticarcillin (8.4 and 9.3%). Ticarcillin was ineffective in reducing viable counts in CSF but, in the presence of clavulanic acid, reduced bacterial numbers by approximately 99% at 4 h after a single dose and by 99.99% at 12 h after three doses given at 4-h intervals. Two doses of ceftazidime given 8 h apart were more effective than the three doses of ticarcillin-clavulanic acid, in keeping with the in vitro activities of these compounds against the infecting organism. These results illustrate the ability of clavulanic acid to penetrate the blood-CSF barrier such that concentrations of the inhibitor in CSF potentiate the activity of ticarcillin against the ticarcillin-resistant, beta-lactamase-producing strain of K. pneumoniae.

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Selected References

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  1. Adam D., Heilmann H. D., Weismeier K. Concentrations of ticarcillin and clavulanic acid in human bone after prophylactic administration of 5.2 g of timentin. Antimicrob Agents Chemother. 1987 Jun;31(6):935–939. doi: 10.1128/aac.31.6.935. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Alestig K., Olaison L., Rylander M. Ceftazidime for Pseudomonas meningitis. Lancet. 1985 Jan 19;1(8421):161–162. doi: 10.1016/s0140-6736(85)91926-9. [DOI] [PubMed] [Google Scholar]
  3. Bennett S., Wise R., Weston D., Dent J. Pharmacokinetics and tissue penetration of ticarcillin combined with clavulanic acid. Antimicrob Agents Chemother. 1983 Jun;23(6):831–834. doi: 10.1128/aac.23.6.831. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chattopadhyay B., Hall I. In vitro activity of ticarcillin plus clavulanic acid (BRL 28500, 'Timentin') against ticarcillin-resistant gram-negative rods. Curr Med Res Opin. 1984;9(3):157–160. doi: 10.1185/03007998409109575. [DOI] [PubMed] [Google Scholar]
  5. Drusano G. L., Standiford H. C., Fitzpatrick B., Leslie J., Tangtatsawasdi P., Ryan P., Tatem B., Moody M. R., Schimpff S. C. Comparison of the pharmacokinetics of ceftazidime and moxalactam and their microbiological correlates in volunteers. Antimicrob Agents Chemother. 1984 Sep;26(3):388–393. doi: 10.1128/aac.26.3.388. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hunter P. A., Coleman K., Fisher J., Taylor D. In vitro synergistic properties of clavulanic acid, with ampicillin, amoxycillin and ticarcillin. J Antimicrob Chemother. 1980 Jul;6(4):455–470. doi: 10.1093/jac/6.4.455. [DOI] [PubMed] [Google Scholar]
  7. Jackson D., Cockburn A., Cooper D. L., Langley P. F., Tasker T. C., White D. J. Clinical pharmacology and safety evaluation of Timentin. Am J Med. 1985 Nov 29;79(5B):44–55. doi: 10.1016/0002-9343(85)90128-7. [DOI] [PubMed] [Google Scholar]
  8. McCracken G. H., Jr Pharmacokinetic and bacteriological correlations between antimicrobial therapy of experimental meningitis in rabbits and meningitis in humans: a review. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):97–108. doi: 10.1093/jac/12.suppl_d.97. [DOI] [PubMed] [Google Scholar]
  9. Modai J. Role of third-generation cephalosporins in the treatment of bacterial meningitis. Chemioterapia. 1986 Oct;5(5):313–318. [PubMed] [Google Scholar]
  10. Nielsen-Kudsk F. Pharmacokinetic analysis and calculations using a program for the minicalculator TI-59. Int J Biomed Comput. 1981 Jan;12(1):83–96. doi: 10.1016/0020-7101(81)90028-3. [DOI] [PubMed] [Google Scholar]
  11. Norrby R. A review of the penetration of antibiotics into CSF and its clinical significance. Scand J Infect Dis Suppl. 1978;(14):296–309. [PubMed] [Google Scholar]
  12. Sakata Y., Boccazzi A., McCracken G. H., Jr Pharmacokinetics and bacteriological effect of ceftazidime in experimental Streptococcus pneumoniae, Haemophilus influenzae, and Escherichia coli meningitis. Antimicrob Agents Chemother. 1983 Feb;23(2):213–217. doi: 10.1128/aac.23.2.213. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sakata Y., McCracken G. H., Jr, Thomas M. L., Olsen K. D. Pharmacokinetics and therapeutic efficacy of imipenem, ceftazidime, and ceftriaxone in experimental meningitis due to an ampicillin- and chloramphenicol-resistant strain of Haemophilus influenzae type b. Antimicrob Agents Chemother. 1984 Jan;25(1):29–32. doi: 10.1128/aac.25.1.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Scheld W. M. Rationale for optimal dosing of beta-lactam antibiotics in therapy for bacterial meningitis. Eur J Clin Microbiol. 1984 Dec;3(6):579–591. doi: 10.1007/BF02013629. [DOI] [PubMed] [Google Scholar]
  15. Sears M. R., O'Donoghue J. M., Fisher H. K., Beaty H. N. Effect of experimental pneumococcal meningitis on respiration and circulation in the rabbit. J Clin Invest. 1974 Jul;54(1):18–23. doi: 10.1172/JCI107740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Sutherland R., Beale A. S., Boon R. J., Griffin K. E., Slocombe B., Stokes D. H., White A. R. Antibacterial activity of ticarcillin in the presence of clavulanate potassium. Am J Med. 1985 Nov 29;79(5B):13–24. doi: 10.1016/0002-9343(85)90124-x. [DOI] [PubMed] [Google Scholar]
  17. Syrogiannopoulos G. A., Al-Sabbagh A., Olsen K. D., McCracken G. H., Jr Pharmacokinetics and bacteriological efficacy of ticarcillin-clavulanic acid (timentin) in experimental Escherichia coli K-1 and Haemophilus influenzae type b meningitis. Antimicrob Agents Chemother. 1987 Sep;31(9):1296–1300. doi: 10.1128/aac.31.9.1296. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Walstad R. A., Hellum K. B., Thurmann-Nielsen E., Dale L. G. Pharmacokinetics and tissue penetration of Timentin: a simultaneous study of serum, urine, lymph, suction blister and subcutaneous thread fluid. J Antimicrob Chemother. 1986 May;17 (Suppl 100):71–80. doi: 10.1093/jac/17.suppl_c.71. [DOI] [PubMed] [Google Scholar]
  19. Woodnutt G., Catherall E. J., Kernutt I., Mizen L. Temocillin efficacy in experimental Klebsiella pneumoniae meningitis after infusion into rabbit plasma to simulate antibiotic concentrations in human serum. Antimicrob Agents Chemother. 1988 Nov;32(11):1705–1709. doi: 10.1128/aac.32.11.1705. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Woodnutt G., Kernutt I., Mizen L. Pharmacokinetics and distribution of ticarcillin-clavulanic acid (Timentin) in experimental animals. Antimicrob Agents Chemother. 1987 Nov;31(11):1826–1830. doi: 10.1128/aac.31.11.1826. [DOI] [PMC free article] [PubMed] [Google Scholar]

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