AB 84. Pharmacokinetics of moxifloxacin in patients with severe exacerbations of COPD
Abstract

AB 84. Pharmacokinetics of moxifloxacin in patients with severe exacerbations of COPD

Maria Sionidou1, Georgia Pitsiou2, Katerina Manika1, Kalliopi Chatzika1, Paschalina Kontou1, Ioannis Kioumis1

1Departement of Pulmonary Medicine, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Respiratory Failure Unit, “G. Papanikolaou” General Hospital, Aristotle University, Thessaloniki, Thessaloniki, Greece

Background: Although moxifloxacin is widely used in patients with COPD exacerbation, its penetration in bronchial secretions has not been evaluated sufficiently. This study aims to investigate pk/pd of moxifloxacin in serum and secretions of patients with severe exacerbations of COPD.

Patients and methods: 13 patients, age 70.77±8.39 years, with presumably infectious exacerbation of COPD were included. 4 patients were admitted in the ICU and 9 in common chambers. All patients received 400 mg intravenous moxifloxacin o.d. and all samples were taken in steady state condition. Venous blood samples were obtained at 0/1/1.5/2/3/4/6/9/12 and 24 hours and bronchial secretions were taken in 0/2/4/6/9/12 and 24 hours. Plasma and bronchial secretions concentrations were measured by a HPLC method using fluorescence detection and pharmacokinetic parameters were determined by the use of WinNonlin software. Penetration was expressed as AUCsecretions/ AUCplasma ratio. Pharmacodynamic target attainment was estimated for the MICs of the most common respiratory pathogens (AUC24/ MIC>30 for Gram positive and >125 for Gram negative pathogens). Drug concentrations in bronchial secretions of patients admitted in the ICU were compared to those of the patients hospitalized in common chambers.

Results: Table 1.

Table 1
Table 1 Analysis of the data.
Full table

pk/pd parameters were similar in both groups with the exception of Cmax in ICU patients bronchial secretions which was lower compared to non critically ill patients (2.5 vs. 5.53 mg/L) but the difference only reached marginal statistical significance (P=0.058).

Conclusions: Moxifloxacin penetration in bronchial secretions in patients with severe exacerbation of COPD appears to be sufficient (90%). Pharmacodynamic target is attained for the most common pathogens, regardless of the required level of care. Lower Cmax in bronchial secretions of ICU patients could be attributed to a variety of reasons, including the co-existence of clinically appreciable hemodynamic alterations.

Cite this abstract as: Sionidou M, Pitsiou G, Manika K, Chatzika K, Kontou P, Zarogoulidis K, Kioumis I. Pharmacokinetics of moxifloxacin in patients with severe exacerbations of COPD. J Thorac Dis 2012;4(S1):AB84. DOI: 10.3978/ j.issn.2072-1439.2012.s084

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