<i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis
<i>Pseudomonas aeruginosa</i> remains one of the major causes of healthcare-associated infection in Europe; in 2019, 12.5% of invasive isolates of <i>P. aeruginosa</i> in Spain presented combined resistance to ≥3 antimicrobial groups. The Spanish nationwide survey on <i>...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Pharmaceutics |
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| Online Access: | https://www.mdpi.com/1999-4923/13/11/1899 |
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| author | Ana Valero Alicia Rodríguez-Gascón Arantxa Isla Helena Barrasa Ester del Barrio-Tofiño Antonio Oliver Andrés Canut María Ángeles Solinís |
| author_facet | Ana Valero Alicia Rodríguez-Gascón Arantxa Isla Helena Barrasa Ester del Barrio-Tofiño Antonio Oliver Andrés Canut María Ángeles Solinís |
| author_sort | Ana Valero |
| collection | DOAJ |
| description | <i>Pseudomonas aeruginosa</i> remains one of the major causes of healthcare-associated infection in Europe; in 2019, 12.5% of invasive isolates of <i>P. aeruginosa</i> in Spain presented combined resistance to ≥3 antimicrobial groups. The Spanish nationwide survey on <i>P. aeruginosa</i> antimicrobial resistance mechanisms and molecular epidemiology was published in 2019. Based on the information from this survey, the objective of this work was to analyze the overall antimicrobial activity of the antipseudomonal antibiotics considering pharmacokinetic/pharmacodynamic (PK/PD) analysis. The role of PK/PD to prevent or minimize resistance emergence was also evaluated. A 10,000-subject Monte Carlo simulation was executed to calculate the probability of target attainment (PTA) and the cumulative fraction of response (CFR) considering the minimum inhibitory concentration (MIC) distribution of bacteria isolated in ICU or medical wards, and distinguishing between sample types (respiratory and non-respiratory). Ceftazidime/avibactam followed by ceftolozane/tazobactam and colistin, categorized as the Reserve by the Access, Watch, Reserve (AWaRe) classification of the World Health Organization, were the most active antimicrobials, with differences depending on the admission service, sample type, and dose regimen. Discrepancies between EUCAST-susceptibility breakpoints for <i>P. aeruginosa</i> and those estimated by PK/PD analysis were detected. Only standard doses of ceftazidime/avibactam and ceftolozane/tazobactam provided drug concentrations associated with resistance suppression. |
| first_indexed | 2024-03-10T05:09:11Z |
| format | Article |
| id | doaj.art-9c1dabd469644d0183e3f4bd6b0a12ac |
| institution | Directory Open Access Journal |
| issn | 1999-4923 |
| language | English |
| last_indexed | 2024-03-10T05:09:11Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceutics |
| spelling | doaj.art-9c1dabd469644d0183e3f4bd6b0a12ac2023-11-23T00:59:21ZengMDPI AGPharmaceutics1999-49232021-11-011311189910.3390/pharmaceutics13111899<i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD AnalysisAna Valero0Alicia Rodríguez-Gascón1Arantxa Isla2Helena Barrasa3Ester del Barrio-Tofiño4Antonio Oliver5Andrés Canut6María Ángeles Solinís7Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray Ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, SpainPharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray Ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, SpainPharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray Ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, SpainInstituto de Investigación Sanitaria Bioaraba, 01006 Vitoria-Gasteiz, SpainMicrobiology Service, Hospital Son Espases, Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, SpainMicrobiology Service, Hospital Son Espases, Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, SpainBioaraba, Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy, 01006 Vitoria-Gasteiz, SpainPharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray Ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain<i>Pseudomonas aeruginosa</i> remains one of the major causes of healthcare-associated infection in Europe; in 2019, 12.5% of invasive isolates of <i>P. aeruginosa</i> in Spain presented combined resistance to ≥3 antimicrobial groups. The Spanish nationwide survey on <i>P. aeruginosa</i> antimicrobial resistance mechanisms and molecular epidemiology was published in 2019. Based on the information from this survey, the objective of this work was to analyze the overall antimicrobial activity of the antipseudomonal antibiotics considering pharmacokinetic/pharmacodynamic (PK/PD) analysis. The role of PK/PD to prevent or minimize resistance emergence was also evaluated. A 10,000-subject Monte Carlo simulation was executed to calculate the probability of target attainment (PTA) and the cumulative fraction of response (CFR) considering the minimum inhibitory concentration (MIC) distribution of bacteria isolated in ICU or medical wards, and distinguishing between sample types (respiratory and non-respiratory). Ceftazidime/avibactam followed by ceftolozane/tazobactam and colistin, categorized as the Reserve by the Access, Watch, Reserve (AWaRe) classification of the World Health Organization, were the most active antimicrobials, with differences depending on the admission service, sample type, and dose regimen. Discrepancies between EUCAST-susceptibility breakpoints for <i>P. aeruginosa</i> and those estimated by PK/PD analysis were detected. Only standard doses of ceftazidime/avibactam and ceftolozane/tazobactam provided drug concentrations associated with resistance suppression.https://www.mdpi.com/1999-4923/13/11/1899<i>Pseudomonas aeruginosa</i>pharmacokinetic/pharmacodynamic (PK/PD) analysisMonte Carlo simulationantimicrobial resistanceprobability of target attainment (PTA)cumulative fraction of response (CFR) |
| spellingShingle | Ana Valero Alicia Rodríguez-Gascón Arantxa Isla Helena Barrasa Ester del Barrio-Tofiño Antonio Oliver Andrés Canut María Ángeles Solinís <i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis Pharmaceutics <i>Pseudomonas aeruginosa</i> pharmacokinetic/pharmacodynamic (PK/PD) analysis Monte Carlo simulation antimicrobial resistance probability of target attainment (PTA) cumulative fraction of response (CFR) |
| title | <i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis |
| title_full | <i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis |
| title_fullStr | <i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis |
| title_full_unstemmed | <i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis |
| title_short | <i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis |
| title_sort | i pseudomonas aeruginosa i susceptibility in spain antimicrobial activity and resistance suppression evaluation by pk pd analysis |
| topic | <i>Pseudomonas aeruginosa</i> pharmacokinetic/pharmacodynamic (PK/PD) analysis Monte Carlo simulation antimicrobial resistance probability of target attainment (PTA) cumulative fraction of response (CFR) |
| url | https://www.mdpi.com/1999-4923/13/11/1899 |
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