Determination of doripenem penetration into human prostate tissue and assessment of dosing regimens for prostatitis based on site-specific pharmacokinetic-pharmacodynamic evaluation

J Chemother. 2012 Feb;24(1):32-7. doi: 10.1179/1120009X12Z.0000000007.

Abstract

Prostatic hypertrophy patients prophylactically received a 0.5-hour infusion of doripenem (250 or 500 mg) before transurethral resection of the prostate. Doripenem concentrations in plasma and prostate tissue were measured chromatographically, and analysed pharmacokinetically using a three-compartment model. The approved doripenem regimens were assessed based on the time above the minimum inhibitory concentration for bacteria (T>MIC, % of 24 hours), an indicator for antibacterial effects, at the prostate. The prostate tissue/plasma ratios were 17.3% for the maximum drug concentration and 18.7% for the area under the drug concentration-time curve, and they were irrespective of the dose. Against Escherichia coli and Klebsiella species isolates, 500 mg once daily achieved a >90% probability of attaining the bacteriostatic target (20% T>MIC) in prostate tissue, and 500 mg twice daily achieved a >90% probability of attaining the bactericidal target (40% T>MIC) in prostate tissue.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacokinetics*
  • Anti-Bacterial Agents / pharmacology*
  • Carbapenems / administration & dosage
  • Carbapenems / pharmacokinetics*
  • Carbapenems / pharmacology*
  • Computer Simulation
  • Doripenem
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Monte Carlo Method
  • Prostate / drug effects*
  • Prostatitis / drug therapy*
  • Tissue Distribution

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Doripenem