A mechanistic understanding of absorption, distribution, metabolism and elimination processes affecting the exposure of ciprofloxacin was comprehensively elucidated in a whole-body physiologically-based pharmacokinetic approach. |
The model was successfully applied to predict age-related changes in pharmacokinetics for pediatric and geriatric patients, using an age-informed physiological database. |
Further pharmacokinetic assessments in other special population groups, or an evaluation of biopharmaceutical issues during formulation development, are potential application scenarios and support subsequent pharmacodynamic model extension. |
1 Introduction
2 Materials and Methods
2.1 Data
Dosage (mg) | Regimen | Infusion time (min) | Population | AUC (mg h/L) | CL (L/h) | References | |||
---|---|---|---|---|---|---|---|---|---|
Age, years (range) | Weight, kg (range) |
n
| Females (%) | ||||||
20 | 30 | 80.85 (60–96) | 20 | 60 | [28] | ||||
25
|
BID
|
10
|
(19–45)
|
(49.9–71.8)
|
9
|
0
| 0.73 ± 0.12 | 1.878 ± 0.324d | [29] |
50 | 3 | 28 (21–34) | 69.3 (61–79) | 8 | 0 | 1.45 ± 0.33 | 33.72 ± 7.29 | [30] | |
50 | 15 | 30 (22–34) | 67 (52–80) | 12 | 50 | 1.23 ± 0.2 | 41.58 ± 7.2 | [31] | |
50
|
15
|
30 (22–34)
|
67.5 (51–80.5)
|
12
|
50
| 1.2 ± 0.2 | 41.22 ± 7.8c | [32] | |
50
|
BID
|
10
|
(19–45)
|
(49.9–71.8)
|
9
|
0
| 1.59 ± 0.15 | 1.908 ± 0.18d | [29] |
75
|
BID
|
10
|
(19–45)
|
(49.9–71.8)
|
9
|
0
| 2.47 ± 0.4 | 2.124 ± 0.408d | [29] |
100 | 30 | 23 | 81.5 | 9 | 0 | 2.24 ± 0.54 | 0.576 ± 0.1254d | [33] | |
100 | 3 | 26 (21–40) | 68 (54–85) | 12 | 50 | 2.54 ± 0.51 | 40.71 ± 7.01 | ||
100 | 3 | 28 (21–34) | 69.3 (61–79) | 8 | 0 | 2.9 ± 0.36 | 32.82 ± 4.344 | [30] | |
100 | 5 | 29 | 75 | 6 | 0 | 9.62 ± 2.29d | [36] | ||
100 | 60 | 29.2 (23–42) | 78.5 (65–85) | 6 | 0 | 2.81 ± 0.57 | 34.02 ± 5.32 | [37] | |
100 | 15 | 30 (22–34) | 67 (52–80) | 12 | 50 | 2.88 ± 0.52 | 36 ± 8.4 | [31] | |
100
|
15
|
30 (22–34)
|
67.5 (51–80.5)
|
12
|
50
| 3 ± 0.5 | 31.8 ± 6.24c | [32] | |
100 | 30 | (21–29) | 6 | 0 | 23 ± 9.1c | [38] | |||
100 | 30 | (21–29) | 6 | 0 | 22.5 ± 8.9c | [38] | |||
100 | 30 | (21–29) | 6 | 0 | 3.94 ± 1.25 | 24.6 ± 10.4c | [38] | ||
100
|
BID
|
30
|
(18–46)
|
(54.8–73)
|
9
|
0
| 3.4 ± 0.49 | 30.1 ± 3.4c | [39] |
150
|
30
|
23
|
81.5
|
9
|
0
| 3.36 ± 0.74 | 0.5742 ± 0.1212d | [33] | |
150 | BID | 30 | (18–46) | (54.8–73) | 9 | 0 | 5.14 ± 0.77 | 29.8 ± 4c | [39] |
200 | 30 | 23 | 81.5 | 9 | 0 | 5.17 ± 0.87 | 0.489 ± 0.0726d | [33] | |
200 | 30 | 24.3 (20–30) | 78 (64–91) | 12 | 0 | 5.2021 ± 1.3916 | 41 ± 11.3 | [40] | |
200 | 25.4 (19–39) | 66.6 (50–82) | 10 | 50 | 5.52 ± 1.95 | [41] | |||
200
|
30
|
27 (19–33)
|
79 (67–83)
|
12
|
0
| 5.37 ± 0.72 | 37.92 ± 4.5 | [6] | |
200 | 10 | 27.1 (22–30) | 77.3 (60.5–89.4) | 8 | 0 | 5.97 ± 0.91 | 26.8 ± 5.71c | [42] | |
200 | 10 | 27.125 (22–30) | 77.3375 (60.5–89.4) | 8 | 0 | 26.8 ± 5.7c | [43] | ||
200 | 30 | 29.3 (21–38) | 67.1 | 12 | 50 | 5.73 ± 1.38 | 36.66 ± 8.04 | [9] | |
200 | 20 | 28 (23–34) | 66 (58–73) | 10 | 50 | 5.31 ± 1.12 | 39.12 ± 7.98 | [31] | |
200 | BID | 60 | 72.6 (65.4–87.6) | 65.6 (42–101) | 17 | 35 | 5.5 ± 1.8a | 0.588 ± 0.258d | [44] |
200 | BID | 30 | 72.96 (44–96) | 67.09 (40–111) | 44 | 95.5 | 13.71 ± 5.5a | [45] | |
200 | 30 | 74 (57–84) | 72 (52–80) | 17 | 0 | 8.17 ± 2.62 | 26.46 ± 7.02 | [46] | |
200 | 30 | 74 (57–84) | 72 (50–80) | 14 | 0 | 8.79 ± 2.73 | 24.42 ± 6.24 | [6] | |
200 | BID | 60 | 77 (66–90) | 66 (49.1–102.7) | 9 | 78 | 13.3 ± 4.8 | 0.2598 ± 0.1194d | [47] |
200
|
30
|
(23–32)
|
75.9
|
12
|
0
| 6.38 ± 1.05 | 32 ± 4.77 | [48] | |
200 | 30 | (21–29) | 6 | 0 | 23.7 ± 5.1c | [38] | |||
200 | 30 | (21–29) | 6 | 0 | 23.3 ± 5c | [38] | |||
200 | 30 | (21–29) | 6 | 0 | 7.22 ± 1.77 | 25.2 ± 5.8c | [38] | ||
200 | 10 | (21–29) | 12 | 0 | 28.5 ± 4.7c | [49] | |||
200 | BID | 30 | (18–46) | (54.8–73) | 9 | 0 | 7.7 ± 1.38 | 26.9 ± 4.1c | [39] |
250
|
5
|
28 (21–34)
|
69.3 (61–79)
|
8
|
0
| 8.11 ± 0.94 | 29.28 ± 3.504 | [30] | |
250 | 5 | 69 (63–76) | 76.9 | 8 | 0 | 8.9 ± 0.83 | 26.04 ± 3.222c | [50] | |
300 | 30 | 24.3 (20–30) | 78 (64–91) | 12 | 0 | 8.7143 ± 1.8886 | 35.7 ± 5.8 | [40] | |
300
|
60
|
27.3 (21–35)
|
73
|
12
|
0
| 8.6 ± 1.5 | 36.18 ± 7.62 | [51] | |
400 | BID | 30 | 24.3 (20–30) | 78 (64–91) | 12 | 0 | 11.0999 ± 1.0934 | 36.5 ± 3.8 | [40] |
400
|
60
|
24.7
|
77.3
|
12
|
0
| 11.2 ± 0.672 | 35.6 ± 2.136 | [25] | |
400 | 25.4 (19–39) | 66.6 (50–82) | 10 | 50 | 11.22 ± 3.5 | [41] | |||
400 | TID | 60 | 25.75 | 74.95 | 12 | 50 | 8.75 ± 1.165 | 31.5 ± 5.355 | [25] |
400 | 60 | 26.8 | 60.2 | 12 | 100 | 14.4 ± 2.304 | 27.7 ± 4.432 | [25] | |
400 | 60 | 27.3 | 74.9 (63.3–84.5) | 6 | 0 | 14.2 ± 1.1 | [52] | ||
400 | 60 | 27.3 (21–35) | 73 | 12 | 0 | 11.4 ± 1.6 | 35.82 ± 4.92 | [51] | |
400 | 60 | 28.2 | 73.3 | 18 | 0 | 24.2 ± 5.1b | 51.72 ± 11.28c | [53] | |
400 | TID | 60 | 28.2 | 73.3 | 18 | 0 | 32.9 ± 8.83b | 38.94 ± 9.96c | [53] |
400 | 60 | 67.7 | 90 | 12 | 0 | 13.7 ± 0.822 | 29.2 ± 1.752 | [25] | |
400 | BID | 60 | 68.25 | 73.3 | 12 | 50 | 0 ± 0 | 24.8 ± 5.208 | [25] |
400 | 60 | 68.8 | 67.9 | 12 | 100 | 19 ± 3.23 | 21.1 ± 3.587 | [25] |
Dosage (mg) | Regimen | Population | AUC (mg h/L) | CL (L/h) | Cmax (mg/L) | References | ||||
---|---|---|---|---|---|---|---|---|---|---|
Age, years (range) | Weight, kg (range) |
n
| Females (%) | |||||||
Suspension
| ||||||||||
10a | BID | (2–4) | 11 | 35 | 1.43 | [54] | ||||
10a | BID | (5–10) | 12 | 35 | 1.44 | [54] | ||||
10a | BID | (11–15) | 10 | 35 | 1.48 | [54] | ||||
10a | TID | 0.675 (0.3–0.8) | 7.675 (6.4–8.8) | 4 | 50 | 10.8 ± 1.28 | 16.4 ± 1.44e | 2.83 ± 1.49 | [55] | |
10a | 0.675 (0.3–0.8) | 7.675 (6.4–8.8) | 4 | 50 | 1.99 ± 1.3 | [55] | ||||
10a | TID | 1.33 (1.1–1.6) | 11 (10.7–11.4) | 3 | 33 | 7.7 ± 1.09 | 18.3 ± 1.22e | 3.57 ± 0.35 | [55] | |
10a | 1.33 (1.1–1.6) | 11 (10.7–11.4) | 3 | 33 | 2.43 ± 1.07 | [55] | ||||
10a | TID | 3.733 (2.5–5.3) | 15.86 (11.9–20) | 5 | 33 | 9 ± 1.33 | 17.3 ± 1.73e | 2.73 ± 1.61 | [55] | |
10a | 3.733 (2.5–5.3) | 15.86 (11.9–20) | 5 | 33 | 2.67 ± 1.12 | [55] | ||||
10a | TID | 6.66 (6.3–7.1) | 22.46 (20.7–23.8) | 4 | 100 | 8.1 ± 1.4 | 24.4 ± 1.28e | 1.95 ± 1.14 | [55] | |
10a | 6.66 (6.3–7.1) | 22.46 (20.7–23.8) | 4 | 100 | 2.08 ± 1.53 | [55] | ||||
15.00a | 0.2 (0.096154–0.26923) | 5.5 (4.1–7.1) | 7 | 43 | 16.1 ± 7.4 | 3.3 ± 1.3 | [56] | |||
15.00a | 2 (1–4.667) | 11.8 (8.3–17.3) | 7 | 43 | 3.93 ± 1.83 | 1.59 ± 0.73 | [56] | |||
500
|
25.7 (19–39)
|
71.3 (57.6–90.7)
|
36
|
0
|
12.0
|
2.4
| [57] | |||
500
|
29.6 (20–40)
|
76.7 (61.9–89.8)
|
32
|
0
|
7.3
|
1.5
| [57] | |||
500
|
29.6 (20–40)
|
76.7 (61.9–89.8)
|
32
|
0
|
8.0
|
1.6
| [57] | |||
500 | (24–40) | 78 | 18 | 0 | 13.5 ± 3.01 | 38.8 ± 9.05 | 3.23 ± 1.13 | [58] | ||
Tablet
| ||||||||||
50 | 30 (22–34) | 67.5 (51–80.5) | 12 | 50 | 1 ± 0.3 | 0.28 ± 0.08 | [32] | |||
100 | 19 | 67.5 (58.5–74) | 6 | 50 | 0.52 ± 0.14 | [59] | ||||
100 | 26 (21–40) | 68 (54–85) | 12 | 50 | 2.1 ± 0.97 | 0.73 ± 0.28 | ||||
100
|
28
|
8
|
0
| 1.289 ± 0.529 | 0.381 ± 0.153 | [2] | ||||
100 | 28 | 7 | 100 | 1.485 ± 0.549 | 0.437 ± 0.154 | [2] | ||||
100 | 29.4 (21–35) | 67 (52–80) | 12 | 50 | 1.77 ± 0.64 | 0.37 ± 0.11 | [31] | |||
100
|
30 (22–34)
|
67.5 (51–80.5)
|
12
|
50
| 1.9 ± 0.6 | 0.49 ± 0.13 | [32] | |||
100 | 74 | 60.25 (30.5–84.2) | 9 | 50 | [59] | |||||
100 | (30–40) | 76.9 (70–85.7) | 4 | 50 | [59] | |||||
200 | 27.1 (22–30) | 77.3 (60.5–89.4) | 8 | 0 | 4.18 ± 1.1 | 39.1 ± 7.28d | 1.18 ± 0.2 | [42] | ||
200 | (21–29) | 12 | 0 | 41.67 ± 6.44 | 1.2055 ± 0.229 | [49] | ||||
250 | 24 (20–30) | 72 (61–81) | 10 | 0 | 5.55 ± 0.34 | 1.2 ± 0.1 | [26] | |||
250
|
BID
|
24.7 (19–45)
|
68.4 (55.2–91)
|
9
|
0
| 5.33 ± 0.61 | 1.35 ± 0.19 | [60] | ||
250 | 25.7 (22–37) | 63 (47.5–79) | 10 | 50 | 1.35 ± 0.17 | [61] | ||||
250 | BID | 25.7 (22–37) | 63 (47.5–79) | 10 | 50 | 1.41 ± 0.32 | [61] | |||
250 | 26 (21–40) | 68 (54–85) | 12 | 50 | 5.28 ± 2.41 | 1.59 ± 0.57 | ||||
250 | 27.3 | 75 | 12 | 0 | 0.823 ± 0.297e | [62] | ||||
250 | BID | 27.3 | 75 | 12 | 0 | 0.629 ± 0.164e | [62] | |||
250
|
BID
|
28
|
8
|
0
| 3.02 ± 0.965 | 0.935 ± 0.331 | [2] | |||
250 | BID | 28 | 8 | 100 | 4.195 ± 1.07 | 1.182 ± 0.236 | [2] | |||
250 | 28 (22–34) | 69.4 | 8 | 0 | 4.7 ± 0.7 | 1.24 ± 0.32 | [50] | |||
250 | 29 | 75 | 6 | 0 | 0.94 ± 0.28 | [36] | ||||
250
|
29.4 (21–35)
|
67 (52–80)
|
10
|
50
| 4.23 ± 1.11 | [31] | ||||
250 | 67 (60–73) | 65 (57–74) | 10 | 40 | 7.43 ± 0.77c | 1.7 ± 0.1 | [26] | |||
250 | 69 (63–76) | 76.9 | 8 | 0 | 6.4 ± 1.08 | 1.47 ± 0.4 | [50] | |||
250 | (22–26) | 8 | 0 | 3.7 ± 1c | 0.76 ± 0.22 | [63] | ||||
500 | 22.3 (19–25) | 62 (59.8–75) | 12 | 50 | 10 ± 2.78 | 38.238 ± 10.14 | 2.26 ± 0.75 | [64] | ||
500 | TID | 22.3 (19–25) | 62 (59.8–75) | 12 | 50 | 13.93 ± 5.32 | 41.436 ± 17.82 | 3.51 ± 1.33 | [64] | |
500 | BID | 24.7 (19–45) | 68.4 (55.2–91) | 9 | 0 | 13.94 ± 2.86b | 2.89 ± 0.54 | [60] | ||
500 | 24.8 (19–40) | 73.3 (57.3–95.5) | 12 | 0 | 11.8 ± 3.6 | [65] | ||||
500 | BID | 24.8 (19–40) | 73.3 (57.3–95.5) | 12 | 0 | 18.5 ± 5.8 | [65] | |||
500 | 25 | 76.2 | 14 | 0 | 10.6 ± 2.3b | 2.5 ± 0.6 | [27] | |||
500 | BID | 25 | 76.2 | 14 | 0 | 14.7 ± 2.7b | 3 ± 0.6 | [27] | ||
500 | BID | 25 (22–40) | 77.4 | 8 | 0 | 10.35 ± 0.86b | [66] | |||
500 | BID | 25.7 (19–39) | 71.3 (57.6–90.7) | 36 | 0 | 11.8 | 2.2 | [57] | ||
500 | 26 (21–30) | 68 (54–85) | 12 | 50 | 9.6 ± 4.2 | 2.8 ± 1.3 | [67] | |||
500 | BID | 26 (21–30) | 68 (54–85) | 12 | 50 | 9.6 ± 4.5 | 2.3 ± 1.1 | [67] | ||
500 | 26 (21–40) | 68 (54–85) | 12 | 50 | 9.61 ± 4.18 | 2.77 ± 1.26 | ||||
500 | 27 (19–42) | 68.3 (57.8–86.6) | 12 | 50 | 10.2 ± 1.9c | 60.06 ± 13.212 | 2.46 ± 0.481 | [68] | ||
500
|
27.3 (21–35)
|
73
|
12
|
0
| 10.7 ± 2.6 | 2.7 ± 0.8 | [51] | |||
500
|
28
|
8
|
0
| 7.383 ± 1.6 | 2.158 ± 0.646 | [2] | ||||
500 | 28 | 7 | 100 | 7.084 ± 2.86 | 1.959 ± 0.503 | [2] | ||||
500 | 28 (22–34) | 69.4 | 8 | 0 | 10.3 ± 2.6 | 2.35 ± 0.52 | [50] | |||
500 | BID | 28 (22–34) | 69.4 | 8 | 0 | 14.3 ± 2.8 | 3.1 ± 0.79 | [50] | ||
500 | BID | 28 (22–33) | 70.4 | 8 | 100 | 12.97 ± 0.75b | [66] | |||
500 | 28.3 (20–42) | 8 | 12.5 | 16.2 ± 4.6 | 3 ± 1 | [69] | ||||
500 | 29 (23–41) | 78 (69–83) | 6 | 0 | 9.9 ± 2.43 | 2.3 ± 0.7 | [70] | |||
500 | 28 (23–34) | 67 (52–80) | 10 | 50 | 6.78 ± 1.32 | 1.51 ± 0.36 | [31] | |||
500 | 30 (19–43) | 74.8 (63–91) | 12 | 50 | 10.6 ± 2.3 | 48.84 ± 13.86 | 2.12 ± 0.5 | [71] | ||
500 | BID | 31 (21–48) | 77.3 | 12 | 50 | [72] | ||||
500 | 36 | 7 | 57 | 10.1 | 2.35 ± 0.95 | [73] | ||||
500 | 60 | 17 | 0 | 9.8 ± 4 | 60.12 ± 27.78 | 2.2 ± 1.1 | [74] | |||
500 | 65.3 | 75.8 | 8 | 0 | [75] | |||||
500 | BID | 67.3 | 77.1 | 8 | 0 | [75] | ||||
500 | 69 (63–76) | 76.9 | 8 | 0 | 13.8 ± 1.75 | 2.83 ± 0.61 | [50] | |||
500 | BID | 69 (63–76) | 76.9 | 8 | 0 | 20.5 ± 3.4 | 3.3 ± 0.38 | [50] | ||
500 | BID | 71 (65–76) | 84.5 | 8 | 0 | 13.68 ± 0.74b | [66] | |||
500 | BID | 72 (65–78) | 67.5 | 8 | 100 | 19.28 ± 1.03b | [66] | |||
500 | BID | 72.6 (65.4–87.6) | 65.6 (42–101) | 17 | 35 | 11.4 ± 4.3b | 0.636 ± 0.222e | 2.6 ± 1 | [44] | |
500 | 75.4 (71–86) | 65.1 (51–79) | 12 | 0 | 20.88 ± 8.68 | 23.64 ± 4.35 | [76] | |||
500 | (24–40) | 78 | 18 | 0 | 10 ± 2.18 | 50.2 ± 11.8 | 2.83 ± 0.68 | [58] | ||
500
|
(24–40)
|
78
|
18
|
0
| 12.7 ± 2.89 | 42 ± 10.2 | 2.91 ± 0.74 | [58] | ||
500 | (22–26) | 11 | 0 | 7.6 ± 2.6c | 1.6 ± 0.79 | [63] | ||||
750 | 23 (19–26) | 78.7 | 12 | 0 | 12.71 ± 2.58 | 28.94 ± 16.43 | 2.23 ± 0.5 | [77] | ||
750 | BID | 24.7 (19–45) | 68.4 (55.2–91) | 9 | 0 | 22.07 ± 6.37b | 4.15 ± 0.72 | [60] | ||
750 | 25 | 76.2 | 14 | 0 | 15.6 ± 3.1b | 3.3 ± 0.7 | [27] | |||
750 | BID | 25 | 76.2 | 14 | 0 | 21.1 ± 6.1b | 4.4 ± 1.1 | [27] | ||
750 | 26 (24–37) | 54.6 (52.3–71.8) | 7 | 100 | 28.3 | 5.2 | [78] | |||
750 | 27.1 (22–30) | 77.3 (60.5–89.4) | 8 | 0 | 15.3 ± 3.77 | 42.2 ± 8.05d | 2.97 ± 0.64 | [42] | ||
750 | 27.3 | 74.9 (63.3–84.5) | 6 | 0 | 19.2 ± 1.1 | 3.9 ± 1.7 | [52] | |||
750 | 27.3 (21–35) | 12 | 0 | 16.8 ± 4.8 | 3.8 ± 15 | [51] | ||||
750
|
28.2
|
73.3
|
18
|
0
| 23.8 ± 7.22c | 70.5 ± 31.14d | 3.01 ± 0.88 | [53] | ||
750 | BID | 28.2 | 73.3 | 18 | 0 | 31.6 ± 12.3c | 53.76 ± 18.36d | 3.59 ± 1.34 | [53] | |
750 | 28 (23–34) | 67 (52–80) | 12 | 50 | 8.77 ± 1.09 | 1.97 ± 0.5 | [31] | |||
750 | 30 (22–34) | 67.5 (51–80.5) | 12 | 50 | 12.2 ± 2.9 | 2.65 ± 0.48 | [32] | |||
750 | 30 (24–43) | 86.6 (67.9–106.8) | 8 | 0 | 44.4 | 3.6 | [78] | |||
750 | 33 | 65 | 24 | 100 | 16.1 ± 3.95 | 47.33 ± 15.46 | 3.19 ± 0.5 | [79] | ||
750
|
36
|
74
|
24
|
0
| 13.42 ± 2.59 | 54.27 ± 10.6 | 3.14 ± 0.77 | [79] | ||
750 | 60 | 17 | 0 | 15.6 ± 9.1 | 70.38 ± 48.9 | 2.8 ± 1.5 | [74] | |||
750 | 60.8 (58–77) | 64.3 (50–93) | 10 | 90 | [80] | |||||
750 | 65.3 (42–85) | 71.8 (62–88) | 10 | 50 | [81] | |||||
750 | 67.8 | 75.8 | 6 | 50 | 20.9 ± 7.7 | 42.1 ± 20 | 5.1 ± 1.4 | [82] | ||
750 | 68.6 | 5 | 0 | [83] | ||||||
750 | 70 (61–82) | 70 (58–80) | 5 | 50 | [84] | |||||
750 | 73 (68–76) | 62.1 (47.7–69.5) | 6 | 0 | 35.1 ± 6.3 | 0.35 ± 0.06e | 5.9 ± 0.7 | [85] | ||
750 | BID | 73 (68–76) | 62.1 (47.7–69.5) | 6 | 0 | 33.1 ± 12.2 | 0.41 ± 0.15e | 6.2 ± 1.8 | [85] | |
750 | BID | 73 (68–76) | 62.1 (47.7–69.5) | 6 | 0 | 34.7 ± 9.8 | 0.38 ± 0.11e | 6.2 ± 1.6 | [85] | |
750 | BID | 78 (66–90) | 63.4 (49.1–66.6) | 6 | 78 | 39.9 ± 11.2 | 7.6 ± 2.2 | [47] | ||
750 | 79.1 (64–92) | 56.5 (43.6–95.7) | 20 | 40 | 41.92 ± 17.22b | 0.4014 ± 0.2238e | 6.58 ± 2.88 | [86] | ||
750 | BID | 79.1 (64–92) | 56.5 (43.6–95.7) | 20 | 40 | 47.7 ± 19.61 | 0.3366 ± 0.1518e | 8.83 ± 2.79 | [86] | |
750 | BID | 81.3 | 10 | 60 | 3.3 ± 2.16 | [87] | ||||
750
|
(23–32)
|
75.9
|
12
|
0
| 16.7 ± 5.1 | 51.9 ± 28.4 | 3.34 ± 1.34 | [48] | ||
750 | (22–26) | 11 | 0 | 12.9 ± 3c | 2.54 ± 0.54 | [63] | ||||
1000 | 26 (21–40) | 68 (54–85) | 12 | 50 | 22.84 ± 9.41 | 5.57 ± 1.21 | ||||
1000 | 28 | 7 | 0 | 11.611 ± 2.998 | 3.619 ± 0.844 | [2] | ||||
1000 | 28 | 8 | 100 | 14.683 ± 5.413 | 3.763 ± 0.924 | [2] | ||||
1000 | (22–26) | 11 | 0 | 16.6 ± 2.4c | 3.38 ± 0.56 | [63] |
Age group | Population | Dosage | References | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age | Females (%) | Weight, kg (range) | Height, cm (range) |
n
| Route | Formulation | mg | mg/kg | Regimen | ||||
Pediatrics | 2 | 15 | Years | 35 | 60 | IV | Suspension | 10 | BID | [88] | |||
0.7 | 70.1 | Years | 54 | 14.3 (6.4–23.8) | 90.5 (65–126) | 16 | IV | Suspension | 10 | TID | [55] | ||
2 | 15 | Years | 35 | 72.1 (66.8–78.8) | 60 | PO | Suspension | 10 | BID | [54] | |||
5 | 14 | Weeks | 43 | 5.5 (4.1–7.1) | 7 | PO | Unknown | 15 | [56] | ||||
1 | 5 | Years | 43 | 11.8 (8.3–17.3) | 7 | PO | Unknown | 15 | [56] | ||||
Elderly | 66 | 90 | Years | 78 | 66 (49.1–102.7) | 168 (149–182) | 9 | IV | Unknown | 200 | [47] | ||
57 | 84 | Years | 0 | 69 (52–80) | 168 (155–175) | 14 | IV | Unknown | 200 | [46] | |||
67 | 83 | Years | 0 | 72 (50–80) | 14 | IV | Solution | 200 | [6] | ||||
65 | 87 | Years | 35 | 65.6 (42–101) | 17 | IV | Solution | 200 | BID | [44] | |||
44 | 96 | Years | 95.5 | 67.09 (40–111) | 160 (150–178) | 44 | IV | Solution | 200 | BID | [45] | ||
63 | 76 | Years | 0 | 76.9 | 8 | IV | Solution | 250 | [50] | ||||
67 | 83 | Years | 0 | 6 | IV | Solution | 400 | TID | [25] | ||||
67 | 83 | Years | 100 | 6 | IV | Solution | 400 | TID | [25] | ||||
60 | 73 | Years | 40 | 65 (57–74) | 10 | PO | Tablet | 250 | [26] | ||||
71 | 86 | Years | 0 | 65.1 (51–79) | 161 (154–170) | 12 | PO | Tablet | 500 | [76] | |||
63 | 76 | Years | 0 | 76.9 | 8 | PO | Tablet | 500 | [50] | ||||
65 | 87 | Years | 35 | 65.6 (42–101) | 17 | PO | Tablet | 500 | BID | [44] | |||
63 | 76 | Years | 0 | 76.9 | 8 | PO | Tablet | 500 | BID | [50] | |||
68 | 76 | Years | 0 | 62.1 (47.7–69.5) | 6 | PO | Tablet | 750 | BID | [85] | |||
61 | 82 | Years | 0 | 70 (58–80) | 15 | PO | Tablet | 750 | [84] | ||||
64 | 92 | Years | 40 | 56.5 (43.6–95.7) | 20 | PO | Tablet | 750 | BID | [86] | |||
58 | 77 | Years | 10 | 64.3 (50–93) | 10 | PO | Unknown | 750 | [80] | ||||
66 | 90 | Years | 78 | 63.4 (49.1–66.6) | 168 (149–182) | 6 | PO | Unknown | 750 | [47] |
2.2 Physiologically-Based Pharmacokinetic (PBPK) Model Development of Ciprofloxacin
2.2.1 Intravenous Administration
2.2.2 Oral Administration and Formulation
2.3 PBPK Model Verification
2.4 Scaling of the Adult Model for Predictions in Pediatric and Geriatric Patients
2.5 Sensitivity Analysis
3 Results
3.1 Intravenous Ciprofloxacin PBPK Model Simulations for Adults
Parameter | Ciprofloxacin PBPK model | |
---|---|---|
Model input value | Sources | |
Physicochemical
| ||
Molecular mass (g/mol) | 331.3 | Drugbank (http://www.drugbank.ca) |
LogP | 0.95 | Estimated using PK-Sim® parameter identification |
pKa | 6.09 (acidic) | Experimentally determined [99] |
8.62 (basic) | Experimentally determined [99] | |
Fraction unbound | 0.67 | Experimentally determined [31] |
Aqueous solubility at pH 7 (mg/mL) | 38.4 | Experimentally determined [100] |
Absorption
| ||
Enhancement factor | ||
Duodenum | 255.8 | Estimated using PK-Sim® parameter identification |
Upper and lower jejunum | 10.4 | Estimated using PK-Sim® parameter identification |
Upper and lower ileum | 11.0 | Estimated using PK-Sim® parameter identification |
Large intestine | 2.3 | Estimated using PK-Sim® parameter identification |
Distribution
| ||
Partition coefficient model | PK-Sim standard | |
Cellular permeability model | PK-Sim standard | |
Metabolism
| ||
CYP1A2-mediated clearance (L/min) | 0.067 | Estimated using PK-Sim® parameter identification |
Elimination pathways | ||
GFR fraction for passive renal clearance | 1 | PK-Sim® default |
Tubular secretion clearance (L/min) | 0.706 | Estimated using PK-Sim® parameter identification |
Biliary clearance (mL/min/kg) | 1.286 | Estimated using PK-Sim® parameter identification |