Pseudomonas aeruginosa Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis

Pseudomonas aeruginosa remains one of the major causes of healthcare-associated infection in Europe; in 2019, 12.5% of invasive isolates of P. aeruginosa in Spain presented combined resistance to ≥3 antimicrobial groups. The Spanish nationwide survey on ...

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Autores principales:	Ana Valero, Alicia Rodríguez-Gascón, Arantxa Isla, Helena Barrasa, Ester del Barrio-Tofiño, Antonio Oliver, Andrés Canut, María Ángeles Solinís
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	<i>Pseudomonas aeruginosa</i> pharmacokinetic/pharmacodynamic (PK/PD) analysis Monte Carlo simulation antimicrobial resistance probability of target attainment (PTA) cumulative fraction of response (CFR) Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/9c1dabd469644d0183e3f4bd6b0a12ac
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spelling	oai:doaj.org-article:9c1dabd469644d0183e3f4bd6b0a12ac2021-11-25T18:41:38Z<i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis10.3390/pharmaceutics131118991999-4923https://doaj.org/article/9c1dabd469644d0183e3f4bd6b0a12ac2021-11-01T00:00:00Zhttps://www.mdpi.com/1999-4923/13/11/1899https://doaj.org/toc/1999-4923<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.Ana ValeroAlicia Rodríguez-GascónArantxa IslaHelena BarrasaEster del Barrio-TofiñoAntonio OliverAndrés CanutMaría Ángeles SolinísMDPI AGarticle<i>Pseudomonas aeruginosa</i>pharmacokinetic/pharmacodynamic (PK/PD) analysisMonte Carlo simulationantimicrobial resistanceprobability of target attainment (PTA)cumulative fraction of response (CFR)Pharmacy and materia medicaRS1-441ENPharmaceutics, Vol 13, Iss 1899, p 1899 (2021)
institution	DOAJ
collection	DOAJ
language	EN
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) Pharmacy and materia medica RS1-441
spellingShingle	<i>Pseudomonas aeruginosa</i> pharmacokinetic/pharmacodynamic (PK/PD) analysis Monte Carlo simulation antimicrobial resistance probability of target attainment (PTA) cumulative fraction of response (CFR) Pharmacy and materia medica RS1-441 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
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.
format	article
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
title	<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_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_sort	<i>pseudomonas aeruginosa</i> susceptibility in spain: antimicrobial activity and resistance suppression evaluation by pk/pd analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9c1dabd469644d0183e3f4bd6b0a12ac
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<i>Pseudomonas aeruginosa</i> Susceptibility in Spain: Antimicrobial Activity and Resistance Suppression Evaluation by PK/PD Analysis

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