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Journal of Antimicrobial Chemotherapy
Article . 2016 . Peer-reviewed
Data sources: Crossref
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Non-linear absorption pharmacokinetics of amoxicillin: consequences for dosing regimens and clinical breakpoints

Authors: de Velde; Femke; de Winter; Brenda C. M.; Koch; Birgit C. P.; van Gelder; Teun; Mouton; Johan W.;

Non-linear absorption pharmacokinetics of amoxicillin: consequences for dosing regimens and clinical breakpoints

Abstract

To describe the population pharmacokinetics of oral amoxicillin and to compare the PTA of current dosing regimens.Two groups, each with 14 healthy male volunteers, received oral amoxicillin/clavulanic acid tablets on two separate days 1 week apart. One group received 875/125 mg twice daily and 500/125 mg three times daily and the other group 500/125 mg twice daily and 250/125 mg three times daily. A total of 1428 amoxicillin blood samples were collected before and after administration. We analysed the concentration-time profiles using a non-compartmental pharmacokinetic method (PKSolver) and a population pharmacokinetic method (NONMEM). The PTA was computed using Monte Carlo simulations for several dosing regimens.AUC0-24 and Cmax increased non-linearly with dose. The final model included the following components: Savic's transit compartment model, Michaelis-Menten absorption, two distribution compartments and first-order elimination. The mean central volume of distribution was 27.7 L and mean clearance was 21.3 L/h. We included variability for the central volume of distribution (34.4%), clearance (25.8%), transit compartment model parameters and Michaelis-Menten absorption parameters. For 40% fT>MIC and >97.5% PTA, the breakpoints were 0.125 mg/L (500 mg twice daily), 0.25 mg/L (250 mg three times daily and 875 mg twice daily), 0.5 mg/L (500 mg three times daily) and 1 mg/L (750, 875 or 1000 mg three times daily and 500 mg four times daily).The amoxicillin absorption rate appears to be saturable. The PTAs of high-dose as well as twice-daily regimens are less favourable than regimens with lower doses and higher frequency.

Country
Netherlands
Keywords

Adult, Male, Adolescent, Dose-Response Relationship, Drug, Administration, Oral, Middle Aged, EMC MM-04-28-01, Amoxicillin-Potassium Clavulanate Combination, Models, Biological, Healthy Volunteers, Absorption, Physiological, Anti-Bacterial Agents, Young Adult, Area Under Curve, Humans, EMC OR-01-34-01, Monte Carlo Method

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
81
Top 1%
Top 10%
Top 10%
bronze