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1.
Chem Biodivers ; : e202400686, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38923804

RESUMO

Pereskia aculeata has been widely investigated due to its anti-inflammatory potential. Among the metabolites found in this species are the phytosterols beta-sitosterol (ß-SIT) and stigmasterol (STIG). The objective of the study was to evaluate the anti-inflammatory and toxicity activities of the hexane partition of P. aculeata (PHEX), as well as ß-SIT and STIG. PHEX was prepared and the phytosterols were quantified. In terms of toxicity against L929 fibroblast cells, PHEX showed toxicity up to 200 µg/mL; STIG and ß-SIT showed toxicity up to 25 µg/mL. PHEX inhibited 66% of nitric oxide radicals, while STIG and ß-SIT inhibited 33.73% and 34.94%, respectively. In an anti-inflammatory test against Zophobas morio larvae, all samples significantly reduced hemocyte levels. Additionally, the LD50 values were calculated: 229.6 mg/kg for PHEX, 101.5 mg/kg for STIG, and 103.8 mg/kg for ß-SIT. In conclusion, the study indicates that the phytosterols present in PHEX may contribute to its anti-inflammatory activity.

2.
Photochem Photobiol Sci ; 23(5): 853-869, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38613600

RESUMO

Synthetic sunscreen offers protection against excessive exposure to ultraviolet (UV) radiation from the sun, and protects the skin from possible damage. However, they have low efficacy against the formation of reactive oxygen species (ROS), which are highly reactive molecules that can be generated in the skin when it is exposed to UV radiation, and are known to play a role in oxidative stress, which can contribute to skin aging and damage. Thus, there is an ongoing search for sunscreens that do not have these negative effects. One promising source for these is natural products. Therefore, the current patent review summarizes topical formulations made from natural compounds that have antioxidant properties and can be used as photoprotective or anti-aging agents, either using a single natural extract or a combination of extracts. The review reports basic patent information (applicant country, type of applicant, and year of filing) and gives details about the invention, including its chemical composition, and the in vitro and in vivo tests performed. These patents describe natural products that can be used to protect the skin and validate their efficacy, and safety, in addition to standardizing their formulations. The compositions described illustrate the consistent innovation in the use of natural products to protect against UV damage and photoaging disorders, a promising field which is receiving growing global recognition.


Assuntos
Produtos Biológicos , Protetores Solares , Raios Ultravioleta , Protetores Solares/farmacologia , Protetores Solares/química , Humanos , Produtos Biológicos/química , Produtos Biológicos/farmacologia , Raios Ultravioleta/efeitos adversos , Patentes como Assunto , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Envelhecimento da Pele/efeitos dos fármacos , Envelhecimento da Pele/efeitos da radiação , Antioxidantes/farmacologia , Antioxidantes/química , Animais , Extratos Vegetais/farmacologia , Extratos Vegetais/química
3.
Curr Med Chem ; 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38659265

RESUMO

INTRODUCTION: During pregnancy, the woman's body undergoes anatomical and physiological changes, making this period susceptible to maternal-fetal diseases and complications. The consequences of not treating pregnant women include premature birth, low birth weight fetuses, and postnatal behavior disorders. Developing new therapies can accelerate the discovery of safe and effective drugs, contributing to designing novel natural and synthetic products to treat complications the pregnancy. OBJECTIVE: This study aimed to carry out a patent review to identify and explore trends in innovation and therapeutic strategies for treating pregnant women. METHODS: The Espacenet and WIPO databases were used, with the inclusion criteria being the keywords "pregnancy and drug" and code A61k, from 2008 to 2023, and as exclusion were the access to the patent and focus on human pregnant women. RESULTS: After the final screening, 32 patents were selected, with strategies for the treatment of diseases in pregnant women. Of these, 20 patents are on preclinical studies on animals and 12 on pregnant women. It was observed that universities lead the ranking of applications (17/32), and China has the highest number of patents (18/32). Most findings contain herbal medicines and/or the association of natural extracts with synthetic drugs. CONCLUSION: From this perspective, new drug administration systems were also developed, which can be a promising source for obtaining new medicines for the treatment of pregnant women; however, research is still limited and shows a gap in stimulating the rapid development of safe drugs that improve the health of pregnant women.

4.
Future Microbiol ; 19(6): 535-557, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38530361

RESUMO

Aim: To examine recent patents related to plants with antimicrobial effects. Methods: Our investigation was carried out using the Espacenet database, searching patents related to International Patent Classification (IPC) codes A61P31/04, and A61K36/00 between 2008 and 2023. Results: The study began with 360 patents, of which 15 were found to be duplicates; 144 were not related to the research topic and six were not available. Then, 48 patents were related to other administration routes. The final selection was 47 patents related to local administration compositions. The potential for these herbal compositions to be marketed as over-the-counter medicines was evident. Conclusion: Developing new plant-origin anti-infective agents could provide promising solutions for combating resistant infections and offer accessible treatment options.


[Box: see text].


Assuntos
Infecções Bacterianas , Patentes como Assunto , Humanos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Administração Tópica , Antibacterianos/uso terapêutico , Antibacterianos/administração & dosagem , Extratos Vegetais/uso terapêutico , Extratos Vegetais/farmacologia , Extratos Vegetais/administração & dosagem , Plantas Medicinais/química , Medicamentos sem Prescrição/uso terapêutico , Medicamentos sem Prescrição/administração & dosagem
5.
Recent Pat Anticancer Drug Discov ; 19(2): 137-145, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-36788702

RESUMO

BACKGROUND: Cannabis use for tumor treatment has been explored in several areas, and its potential for tumor remission is currently being studied after the discovery of the endogenous cannabinoid. OBJECTIVE: The study aimed to conduct a critical patent review to identify and explore the latest advances and therapeutic strategies using Cannabis to treat cancer. METHODS: The research was carried out in the free and online database Espacenet, using the descriptors "cancer" and "Cannabis or cannabidiol" in the title or abstract. A total of 95 patents were identified for preliminary evaluation in the database. Six duplicate patents were excluded, 12 referring to traditional Chinese medicine and 36 with a title in disagreement with the scope of this review. In addition the final selection involved 21 patents that were in line with the objective of the study. RESULTS: As observed in the reading of patents, the interest of pharmaceutical industries and researchers and the development of new products to fight cancer have increased in recent years. The main cannabinoids present in the patents are tetrahydrocannabinol, cannabidiol, and hemp. Moreover, the patents were classified and the main applicant countries were the United States followed by Japan, with a higher filing rate in 2019 and, mainly by the industry. CONCLUSION: In conclusion we can say that, the importance of parliamentary approval in the cultivation and investments that, in addition to bringing innovation to the industrial sector, enriches research in the area, contributing to the creation of new medicines.


Assuntos
Canabidiol , Canabinoides , Cannabis , Neoplasias , Humanos , Estados Unidos , Canabidiol/uso terapêutico , Patentes como Assunto , Canabinoides/uso terapêutico , Neoplasias/tratamento farmacológico
7.
Curr Drug Res Rev ; 2023 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-37861009

RESUMO

BACKGROUND: Acute rejection remains one of the main complications in the first months after transplantation and may influence long-term outcomes. Tacrolimus has proven its usefulness in solid organ transplants and its monitoring through the application of pharmacokinetic concepts to optimize individual drug therapy. OBJECTIVE: This research proposes to evaluate the tacrolimus pharmacokinetic parameters in patients suspected of acute kidney graft rejection under methylprednisolone pulse therapy. METHODS: Eleven adult tacrolimus-treated renal recipients were selected from a prospective, single-arm, single-center cohort study, with suspicion of acute rejection although in use of methylprednisolone pulses therapy. They were followed up for three months posttransplantation, being tacrolimus trough serum concentrations determined using a chemiluminescent magnetic immunoassay, and pharmacokinetic parameters were estimated by using a nonlinear mixed-effects model implemented by Monolix 2020R1. A tacrolimus trough serum concentration range of 8 to 12 ng.mL-1 was considered therapeutic. RESULTS: Six patients showed acute cellular rejection, and two of them in addition had an antibody- mediated rejection. Tacrolimus trough serum concentration was below the reference range in eight patients. Most patients showed a high tacrolimus concentration intrapatient and pharmacokinetic parameters variability. CONCLUSION: The obtained pharmacokinetics parameters helped in understanding the kidney recipient patients' tacrolimus behavior, assisting in the improvement of individual drug therapy and reducing the risk of acute rejection episodes.

8.
Curr Med Chem ; 2023 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-37592768

RESUMO

BACKGROUND: Acne is a highly prevalent disease that mainly affects the pilosebaceous units associated with sebaceous glands, causing inflammatory skin lesions and affecting the self-esteem, mental health, and quality of life of those who suffer from this disease. Different treatments exist today to prevent, reduce, and improve symptoms; however, over the years, there have been problems with bacterial resistance and slight effectiveness with prolonged use. OBJECTIVE: The purpose of this article is based on the review of patents of new products of principal topical administration for the treatment of acne in recent years 2016-2020, to evaluate and analyze novel synthetic molecules and semi-synthetics with potential therapeutic and preventive in the acne treatment. METHODS: A systematic review of patents was conducted through the official database of the European Patent Office - Espacenet, where the search focused on the keywords: "acne and bacteria" in the title or abstract. Only patents granted between the years 2016-2020 were included, with products having molecules with a synthetic and semi-synthetic origin, without considering natural, biological products or those used as diagnostic means. RESULTS: A total of 19 patents were selected, most with principally antimicrobial and anti-inflammatory action, where the reduction in the appearance of resistance by C. acnes is verified, and its action is complemented by inhibiting the different pathophysiological mechanisms that lead to the worsening of the disease. CONCLUSION: Novel approaches in the treatment and prevention of acne, mainly topically, are focused on the reduction of bacterial resistance and irritation compared to current treatments. The use of combined formulations provides better results with additional benefits, improving treatment times and patient adherence.

9.
Pharmaceutics ; 15(7)2023 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-37513968

RESUMO

Voriconazole is a triazole antifungal used empirically for the treatment of complicated meningitis associated with Cryptococcus neoformans. Biopsy studies show that the drug exhibits adequate brain penetration although levels of cerebral spinal fluid (CSF) are highly variable. Considering that CSF is one of the main surrogates for CNS exposure, the present work proposed the building of a population pharmacokinetic modeling (popPK) model able to describing the exposure achieved by voriconazole in the plasma, interstitial cerebral fluid and CSF of healthy and infected rats. The developed popPK model was described by four compartments, including total plasma, free brain and total CSF concentrations. The following PK parameters were determined: Km = 4.76 mg/L, Vmax = 1.06 mg/h, Q1 = 2.69 L, Qin = 0.81 h-1 and Qout = 0.63 h-1. Infection was a covariate in the Michaelis-Menten constant (Km) and intercompartmental clearance from the brain tissue compartment to central compartment (Qout). Simulations performed with the popPK model to determine the probability of reaching the therapeutic target of fAUC > MIC showed that VRC has sufficient tissue exposure in the interstitial fluid and in the CSF for the treatment of fungal infections in these tissues at prevalent minimum inhibitory concentrations.

10.
Food Res Int ; 170: 113013, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37316080

RESUMO

Fruits have relevant usefulness in the elaboration of nutraceutical compositions and, as it is considered a "natural medicine", its market has been growing exponentially each year. Fruits, in general, contain a large source of phytochemicals, carbohydrates, vitamins, amino acids, peptides and antioxidants that are of interest to be prepared as nutraceuticals. The biological properties of its nutraceuticals can range from antioxidant, antidiabetic, antihypertensive, anti-Alzheimer, antiproliferative, antimicrobial, antibacterial, anti-inflammatory, among others. Furthermore, the need for innovative extraction methods and products reveals the importance of developing new nutraceutical compositions. This review was developed by searching patents of nutraceuticals from January 2015 until January 2022 in Espacenet, the search database of the European Patent Office (EPO). Of 215 patents related to nutraceuticals, 43% (92 patents) were including fruits, mainly berries. A great number of patents were focused on the treatment of metabolic diseases, representing 45% of the total patents. The principal patent applicant was the United States of America (US), with 52%. The patents were applied by researchers, industries, research centers and institutes. It is important to highlight that from 92 fruit nutraceutical patent applications reviewed, 13 already have their products available on the market.


Assuntos
Suplementos Nutricionais , Frutas , Antioxidantes , Vitaminas , Aminoácidos
11.
Mycopathologia ; 187(5-6): 535-546, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36194378

RESUMO

Candida auris is responsible for hospital outbreaks worldwide. Some C. auris isolates may show concomitant resistance to azoles, echinocandins, and polyenes, thereby possibly leaving clinicians with few therapeutic options. In addition, this multi-drug-resistant yeast is difficult to identify with conventional methods and has the ability to persist on environmental surfaces causing hospital-acquired infections. The development of new treatment options and tools for identification is critical to control, prevent, and establish an early diagnosis of this emerging pathogen. The aim of this study was to perform a critical patent review to explore and identify the latest advances in therapeutic strategies as well as diagnostic methods for C. auris. A total of 19 patents were identified for a preliminary assessment from the Espacenet database. Three patents were excluded as they were out of focus for this review according to their abstract and/or description. The final selection covered 16 patents, which were surveyed by country, year and classified as treatment or diagnostic methods for C. auris. As noted in the patent reading, in recent years, the interest of academic, government and industry sectors have shown an increasing tendency focused on research and development of new therapeutic molecules and diagnostic methods to combat this emerging pathogen.


Assuntos
Candidíase , Farmacorresistência Fúngica Múltipla , Candida , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Candida auris , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Testes de Sensibilidade Microbiana
12.
Future Microbiol ; 17: 1421-1432, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36169343

RESUMO

Drugs used to fight fungal infections may cause toxic or adverse drug interactions. For this reason, there is an increase in the development of natural, semisynthetic and synthetic antifungal peptides. This study aimed to perform a patent review to identify the advances in peptides to treat fungal infections. In a preliminary assessment, 597 patents were identified from the database. Then, duplicated patents (62) and those with titles in disagreement with the scope of this review (196) were excluded. Then, six patents were not in English or Spanish. Following the screening, 288 patents were outside the focus of this review, according to their abstract and description. The final selection covered 45 patents.


Currently, medications used to treat fungal infections may interact negatively with other drugs or be hazardous to the host. Scientists have been looking for novel, safe and efficient antifungal drugs since the enhancement of fungal resistance. Antimicrobial peptides, as opposed to traditional antibiotics, offer a variety of antibacterial activity against bacteria, fungi, parasites, viruses and cancer cells. The production of isolated natural, semisynthetic and synthetic antifungal peptides has increased. As a result, patents are a reliable and up-to-date source of innovation. As a result, their content analysis provides crucial information for identifying trends in new medications and targeted treatment plans.


Assuntos
Antifúngicos , Micoses , Humanos , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Micoses/tratamento farmacológico , Micoses/microbiologia , Peptídeos/farmacologia , Peptídeos/uso terapêutico
13.
Future Microbiol ; 17: 1393-1408, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36169345

RESUMO

Background: Antimicrobial resistance has been a threat to human health ever since the accelerated consumption of antibiotics began. Materials & methods: The present systematic review was carried out using a free and specialized online database - Espacenet - and a survey for patents of antimicrobial agents from 2010 to 2021, selecting 33 recent patents that claimed compounds with antimicrobial activity against resistant strains of Gram-negative bacteria. Results: Some different and new approaches to the development of the patented antibacterial agents were identified, such as antimicrobial peptides, nanomaterials and natural extracts. Conclusion: Some alternatives to modern antibiotics with diminished effectiveness due to antimicrobial resistance were spotted. Nevertheless, many challenges remain to establish a robust and sustainable antibacterial R&D pipeline.


Assuntos
Farmacorresistência Bacteriana Múltipla , Bactérias Gram-Negativas , Humanos , Antibacterianos/uso terapêutico , Testes de Sensibilidade Microbiana
14.
Antibiotics (Basel) ; 11(8)2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35892376

RESUMO

Pharmacokinetics and pharmacodynamics are areas in pharmacology related to different themes in the pharmaceutical sciences, including therapeutic drug monitoring and different stages of drug development. Although the knowledge of these disciplines is essential, they have historically been treated separately. While pharmacokinetics was limited to describing the time course of plasma concentrations after administering a drug-dose, pharmacodynamics describes the intensity of the response to these concentrations. In the last decades, the concept of pharmacokinetic/pharmacodynamic modeling (PK/PD) emerged, which seeks to establish mathematical models to describe the complete time course of the dose-response relationship. The integration of these two fields has had applications in optimizing dose regimens in treating antibacterial and antifungals. The anti-infective PK/PD models predict the relationship between different dosing regimens and their pharmacological activity. The reviewed studies show that PK/PD modeling is an essential and efficient tool for a better understanding of the pharmacological activity of antibacterial and antifungal agents.

15.
Artigo em Inglês | MEDLINE | ID: mdl-35378013

RESUMO

Self-emulsifying drug delivery systems (SEDDS) are lipid-based isotropic mixtures that enhance the bioavailability of poorly water-soluble drugs and reduce the possible side effects, offering a wide variety of treatments for several pathologies. The aim of this review is to discuss the state of the art of patents for this drug delivery system by studying recent patent applications (2011 to 2020). We performed a thorough screening using the European Patent Office's Espacenet database, from which 37 inventions were selected and fully studied. China had more patent applications, and the articles published about SEDDS exceeds both in number and technological advance the submitted inventions. Nevertheless, the patents presented herein are innovative to address known issues to traditional SEDDS, including storage and formulation stability, solid formulations, acute gastrointestinal toxicity from surfactants, and drug delivery through alternative routes of administration. This study also revealed that release behavior for SEDDS and associated pharmacokinetics were not completely disclosed by the inventors of the patents and that further studies are required.


Assuntos
Sistemas de Liberação de Medicamentos , Tensoativos , Disponibilidade Biológica , China , Emulsões , Humanos
16.
Pharmaceutics ; 15(1)2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36678714

RESUMO

Diabetes mellitus (DM) is a metabolic syndrome that can be considered a growing health problem in the world. High blood glucose levels are one of the most notable clinical signs. Currently, new therapeutic alternatives have been tackled from clinicians' and scientists' points of view. Natural products are considered a promising source, due to the huge diversity of metabolites with pharmaceutical applications. Therefore, this review aimed to uncover the latest advances in this field as a potential alternative to the current therapeutic strategies for the treatment of DM. This purpose is achieved after a patent review, using the Espacenet database of the European Patent Office (EPO) (2016-2022). Final screening allowed us to investigate 19 patents, their components, and several technology strategies in DM. Plants, seaweeds, fungi, and minerals were used as raw materials in the patents. Additionally, metabolites such as tannins, organic acids, polyphenols, terpenes, and flavonoids were found to be related to the potential activity in DM. Moreover, the cellular transportation of active ingredients and solid forms with special drug delivery profiles is also considered a pharmaceutical technology strategy that can improve their safety and efficacy. From this perspective, natural products can be a promissory source to obtain new drugs for DM therapy.

17.
NPJ Sci Food ; 5(1): 28, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725351

RESUMO

Recently, many consumers have been adding plant-based beverages to their diets, due to different reasons. The addition of plant proteins to enrich these products in order to make them more nutritionally balanced has become a trend, mainly because of their lower prices and reduced environmental damage. Thus, the aims of the present patent review are to discuss the potential of, and challenges posed by, plant proteins to the beverage industry, as well as to check market trends, focused on raw materials and beverage types. Based on the results, pea, rapeseed, bean, peanut, chickpea, lentil, hempseed, sunflower seed, and cottonseed were among the most often addressed raw materials. Furthermore, this enrichment process is not limited to create products that mimic dairy, therefore expansion in plant proteins used to enrich carbonated beverages, sports drinks, or even juices is expected to happen. Thus, plant-derived proteins have been promising to high-quality beverage production, as well as to ensure food security, animal welfare, and low environmental impacts.

18.
Crit Rev Ther Drug Carrier Syst ; 38(6): 105-125, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34587430

RESUMO

In recent years, allergies are on the rise. The growth of allergies cases has changed the immune system's response to new pathogens. The therapy used to treat these diseases is based on allergen avoidance, pharmacotherapy and allergen-specific immunotherapy. The last one has received a lot of interest in the research field, due to the possibility of leading the patient to a cure. In this sense, new allergen immunotherapy need to be developed or improved to increase safety and efficiency. This review aims to evaluate patents published, from 2015 to July 2020, that have developed allergic immunotherapy treatment and administration routes, as well as new alternatives of vehicles, carriers and delivery systems in this context. The advance of new patents has been mostly seen in China and United States. The oral route is the most used in the development of new allergy treatments. However, due to the challenges that still exist in allergy therapy, association with other pathways is interesting to amplify the possibilities and alternatives of treatment. Thus, other routes of administration for allergen-specific immunotherapy such as topical, sublingual and intranasal have been explored in the research and industrial fields. Nevertheless, it has been observed that few studies are using these alternative administration routes, probably due to the higher cost and lack of investments. The delivery systems are also other tools that can be more explored in the allergen immunotherapy formulations. The effectiveness, safety and acceptance of this therapy depends on the development of new formulations and routes of administration.


Assuntos
Dessensibilização Imunológica , Hipersensibilidade , Administração Oral , Administração Sublingual , Alérgenos , Humanos , Hipersensibilidade/terapia
19.
Arq Neuropsiquiatr ; 79(8): 732-742, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34550191

RESUMO

BACKGROUND: Insomnia is a sleep disorder characterized by difficulty of falling asleep or maintaining sleep, which affects different age groups. Currently, melatonin is used as a therapeutic treatment in cases of insomnia in children, adults, and elderly people. OBJECTIVE: To evaluate the effectiveness of melatonin in sleep disorders, its dosage, potential adverse effects, as well as labeling laws and regulations in Brazil. METHODS: This integrative review was carried out using the Cochrane Library, Medline (Pubmed), and Science Direct databases. Twenty-five articles and three documents available on the Brazilian Society of Endocrinology and Metabology (SBEM) and National Health Surveillance Agency (ANVISA) websites published between 2015 and 2020 were selected to be evaluated in full. RESULTS: It was found that in most of the selected articles the use of melatonin reduces sleep latency. The effective melatonin doses varied according to each age group, from 0.5 to 3 mg in children, 3 to 5 mg in adolescents, 1 to 5 mg in adults, and 1 to 6 mg in elderly people. Side effects are mild when taking usual doses. In Brazil, no registered drug and current regulation on the use and marketing of melatonin has been identified. CONCLUSION: The use of melatonin is an alternative therapy that can be used for sleeping disorders. According to the evidences found, it did not demonstrate toxicity or severe side effects, nor dependence even when administered at high doses, suggesting that it is a safe medication to treat patients of different ages suffering from sleeping disorders.


Assuntos
Melatonina , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Adolescente , Adulto , Idoso , Brasil , Criança , Humanos , Melatonina/uso terapêutico , Sono , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Transtornos do Sono-Vigília/tratamento farmacológico
20.
Braz J Microbiol ; 52(4): 1967-1979, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34337679

RESUMO

OBJECTIVES: The aim of this study was to investigate the effect of daptomycin against methicillin-resistant staphylococci (MRSA and MRSE) bacteremia using computer modeling. METHODS: A pharmacokinetic/pharmacodynamic (PK/PD) modeling strategy to explain the data from an in vitro dynamic model employing time-kill curves for MRSA and MRSE was proposed. Bacterial killing was followed over time by determining viable counts and the resulting time-kill data was analyzed. Monte Carlo simulations were performed using pharmacokinetic parameters and pharmacodynamic data to determine the probabilities of target attainment and cumulative fractions of response in terms of area under the concentration curve/minimum inhibition concentration (MIC) targets of daptomycin. Simulations were conducted to assess the reduction in the number of colony-forming units (CFU)/mL for 18 days of treatment with daptomycin at doses of 6, 8, and 10 mg/kg/24 h or 48 h with variations in creatinine clearance (CLCR): 15-29 mL/min/1.73 m2, 30-49 mL/min/1.73 m2, 50-100 mL/min/1.73 m2, as well as for defining the probability of reaching the target fAUC/MIC = 80 in the same dose and clearance range. A PK/PD model with saturation in the number of bacteria in vitro, growth delay, and bacterial death, as well as Hill's factor, was used to describe the data for both MRSA and MRSE. RESULTS: Monte Carlo simulations showed that for MRSA there was a reduction > 2 log CFU/mL with doses ≥ 6 mg/kg/day in 75th percentile of the simulated population after 18 days of treatment with daptomycin, whereas for MRSE this reduction was observed in 95th percentile of the population. CONCLUSIONS: The presented in vitro PK/PD model and associated modeling approach were able to characterize the time-kill kinetics of MRSA and MRSE. Our study based on PTAs suggests that doses ≥ 6 mg/kg/day of daptomycin should be used to treat bacteremia caused by MRSA and MRSE in patients with CLCR of 15-29 mL/min/1.73 m2. For patients with CLCR ≥ 50 mL/min/1.73 m2, it would be necessary to employ a dose of 10 mg/kg/day to treat complicated bacteremias.


Assuntos
Bacteriemia , Daptomicina , Staphylococcus aureus Resistente à Meticilina , Método de Monte Carlo , Infecções Estafilocócicas , Antibacterianos/farmacocinética , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Daptomicina/farmacocinética , Daptomicina/farmacologia , Daptomicina/uso terapêutico , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/tratamento farmacológico
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