Population pharmacokinetics of intravenous moxifloxacin 400 mg once-daily dosage in infected patients

Moxifloxacin loaded nanoparticles of disulfide bridged thiolated chitosan-eudragit RS100 for controlled drug delivery

The aim of our study was to prepare nanoparticles of disulfide bridged thiolated chitosan and eudragit RS100 using the air oxidation method for controlled drug delivery. The developed nanoparticles were characterized by FTIR, DSC, TGA, zeta sizer, zeta potential, SEM and ¹H NMR. The loading, entrapment efficiency and in-vitro release of moxifloxacin from nanoparticles was determined. Toxicity was studied using Caco-2 cell line and pharmacokinetics of moxifloxacin from the developed nanoparticles was studied in albino rats. The FTIR analysis showed no chemical interaction of the drug with the thiolated polymers. The DSC and TGA showed the thermal stability of nanoparticles. The average particle size of nanoparticles was 87 nm, zeta potential of NTC3 was ± 19 and SEM showed the spherical shape of nanoparticles. The ¹H NMR spectra confirmed the structure of thiolated chitosan and eudragit RS100. The loading, encapsulation efficiency and release of moxifloxacin from NTC3 were 100.3%, 89.67% and 88.49% respectively. The nanoparticles in culture medium did not affect the viability of Caco-2 cells. The NTC3 formulation showed a greater bioavailability of moxifloxacin compared to the reference formulation. The study reports a convenient and effective way to prepare a chitosan and eudragit RS100 based drug delivery system with a controlled release pattern.

The Pharmacokinetics of Moxifloxacin in Cerebrospinal Fluid Following Intravenous Administration: A Report of Successfully Treated Infant with Mycoplasma hominis Meningitis

A female infant underwent myelomeningocele repair and developed persistent ventricular dilatation. Cerebrospinal fluid (CSF) indices demonstrated meningitis with cultures growing Mycoplasma hominis. The infant was treated with multiple antibiotics including moxifloxacin. Moxifloxacin CSF levels were obtained for pharmacokinetic analysis. This case report adds the importance of understanding the pharmacokinetics of CSF moxifloxacin levels among infants.

Application of Physiologically-Based and Population Pharmacokinetic Modeling for Dose Finding and Confirmation During the Pediatric Development of Moxifloxacin

Moxifloxacin is a widely used fluoroquinolone for the treatment of complicated intra‐abdominal infections. We applied physiologically‐based pharmacokinetic (PBPK) and population pharmacokinetic (popPK) modeling to support dose selection in pediatric patients. We scaled an existing adult PBPK model to children based on prior physiological knowledge. The resulting model proposed an age‐dependent dosing regimen that was tested in a phase I study. Refined doses were then tested in a phase III study. A popPK analysis of all clinical pediatric data confirmed the PBPK predictions, including the proposed dosing schedule in children, and supported pharmacokinetics‐related safety/efficacy questions. The pediatric PBPK model adequately predicted the doses necessary to achieve antimicrobial efficacy while maintaining safety in the phase I and III pediatric studies. Altogether, this study retroactively demonstrated the robustness and utility of modeling to support dose finding and confirmation in pediatric drug development for moxifloxacin.

Comparison of the in vitro activity of ampicillin and moxifloxacin against Listeria monocytogenes at achievable concentrations in the central nervous system

PURPOSE

The aim of this study was to compare the in vitro activity of ampicillin and moxifloxacin against six isolates selected from 154 invasive clinical isolates of Listeria monocytogenes and evaluate their intra- and extracellular activities with achievable central nervous system concentrations obtained using Monte Carlo simulations with conventional and unconventional dosages.

METHODOLOGY

The MICs and minimal bactericidal concentrations (MBCs) of ampicillin and moxifloxacin were determined by using the broth microdilution method. The intra- and extracellular activities were compared using time-kill curves and inhibition of intracellular growth assays.

RESULTS

The MICs50/90 of ampicillin were 0.125/0.5 mg l-1 and the MBC50/90 was ≥16 mg l-1, while the moxifloxacin MICs50/90 were 0.25/0.5 mg l-1 and the MBC50/90 was 0.5 mg l-1. Ampicillin did not show any extracellular bactericidal activity at 24 h, although bactericidal activity was detected at 48 h. For moxifloxacin, the bactericidal effect was evident after 6 h of incubation. Both antibiotics achieved significant reductions in intracellular inoculum after 1-24 h of incubation; however, moxifloxacin becomes bactericidal more rapidly, producing a much greater reduction in the inoculum in the first hour than ampicillin. There were no differences among the MIC and MBC values of moxifloxacin and ampicillin among the strains belonging to different serotypes and/or epidemic clones. This fact was also found in the intra- and extracellular studies.

CONCLUSION

The results of this study demonstrated the faster bactericidal activity of moxifloxacin at achievable central nervous system concentrations against intra- and extracellular forms of L. monocytogenes in comparison with ampicillin.