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Oral bioavailability of moxifloxacin after Roux-en-Y gastric bypass surgery

Julie De Smet UGent, Pieter Colin UGent, Peter De Paepe UGent, Johannes Ruige UGent, Hélène Batens, Yves Van Nieuwenhove UGent, Dirk Vogelaers UGent, Stijn Blot UGent, Jan Van Bocxlaer UGent and Lucas Van Bortel UGent, et al. (2012) JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY. 67(1). p.226-229
abstract
Objectives: Roux-en-Y gastric bypass surgery is the most commonly performed procedure for the treatment of morbid obesity. This anatomical alteration may affect the absorption and consequently the bioavailability of oral drugs. This study aims to investigate the oral bioavailability of moxifloxacin in 12 healthy volunteers who underwent gastric bypass surgery. Patients and methods: In this randomized crossover study, each subject received two single standard doses of 400 mg of moxifloxacin orally or intravenously administered on two occasions separated by a washout period of 1 week. Serial venous blood samples were drawn up to 72 h after dosing and moxifloxacin plasma levels were measured by a validated HPLC method with fluorescence detection. [clinicaltrials.gov database (identifier: NCT01130922).] Results: After oral dosing, moxifloxacin plasma concentrations reached a maximum (C-max) of 3.38 +/- 1.41 mg/L after 1.75 h (0.75-4.00). After intravenous dosing, C-max and T-max were 4.53 +/- 1.43 mg/L and 1.03 h (0.75-2.50), respectively. The mean areas under the plasma concentration time curve extrapolated to infinity (AUC(infinity)) were 46.2 +/- 1.4 mg.h/L after oral dosing and 52.3 +/- 1.3 mg.h/L after intravenous dosing, resulting in a mean oral bioavailability of 88.32% [90% confidence interval (CI) 85.64%-91.08%]. Conclusions: This study confirms that exposure to moxifloxacin is equivalent for oral and intravenous administration of 400 mg dosages in healthy volunteers who underwent gastric bypass surgery. But these exposures were more than 50% higher than those described for subjects without gastric bypass. This may suggest a higher enterohepatic recirculation of moxifloxacin after gastric bypass.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
pharmacokinetics, PHARMACOKINETICS, bariatric surgery, fluoroquinolones
journal title
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
J. Antimicrob. Chemother.
volume
67
issue
1
pages
226 - 229
Web of Science type
Article
Web of Science id
000300833700034
JCR category
PHARMACOLOGY & PHARMACY
JCR impact factor
5.338 (2012)
JCR rank
18/259 (2012)
JCR quartile
1 (2012)
ISSN
0305-7453
DOI
10.1093/jac/dkr436
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2137703
handle
http://hdl.handle.net/1854/LU-2137703
date created
2012-06-08 16:21:42
date last changed
2012-06-26 10:25:50
@article{2137703,
  abstract     = {Objectives: Roux-en-Y gastric bypass surgery is the most commonly performed procedure for the treatment of morbid obesity. This anatomical alteration may affect the absorption and consequently the bioavailability of oral drugs. This study aims to investigate the oral bioavailability of moxifloxacin in 12 healthy volunteers who underwent gastric bypass surgery. 
Patients and methods: In this randomized crossover study, each subject received two single standard doses of 400 mg of moxifloxacin orally or intravenously administered on two occasions separated by a washout period of 1 week. Serial venous blood samples were drawn up to 72 h after dosing and moxifloxacin plasma levels were measured by a validated HPLC method with fluorescence detection. [clinicaltrials.gov database (identifier: NCT01130922).] 
Results: After oral dosing, moxifloxacin plasma concentrations reached a maximum (C-max) of 3.38 +/- 1.41 mg/L after 1.75 h (0.75-4.00). After intravenous dosing, C-max and T-max were 4.53 +/- 1.43 mg/L and 1.03 h (0.75-2.50), respectively. The mean areas under the plasma concentration time curve extrapolated to infinity (AUC(infinity)) were 46.2 +/- 1.4 mg.h/L after oral dosing and 52.3 +/- 1.3 mg.h/L after intravenous dosing, resulting in a mean oral bioavailability of 88.32\% [90\% confidence interval (CI) 85.64\%-91.08\%]. 
Conclusions: This study confirms that exposure to moxifloxacin is equivalent for oral and intravenous administration of 400 mg dosages in healthy volunteers who underwent gastric bypass surgery. But these exposures were more than 50\% higher than those described for subjects without gastric bypass. This may suggest a higher enterohepatic recirculation of moxifloxacin after gastric bypass.},
  author       = {De Smet, Julie and Colin, Pieter and De Paepe, Peter and Ruige, Johannes and Batens, H{\'e}l{\`e}ne and Van Nieuwenhove, Yves and Vogelaers, Dirk and Blot, Stijn and Van Bocxlaer, Jan and Van Bortel, Lucas and Boussery, Koen},
  issn         = {0305-7453},
  journal      = {JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY},
  keyword      = {pharmacokinetics,PHARMACOKINETICS,bariatric surgery,fluoroquinolones},
  language     = {eng},
  number       = {1},
  pages        = {226--229},
  title        = {Oral bioavailability of moxifloxacin after Roux-en-Y gastric bypass surgery},
  url          = {http://dx.doi.org/10.1093/jac/dkr436},
  volume       = {67},
  year         = {2012},
}

Chicago
De Smet, Julie, Pieter Colin, Peter De Paepe, Johannes Ruige, Hélène Batens, Yves Van Nieuwenhove, Dirk Vogelaers, et al. 2012. “Oral Bioavailability of Moxifloxacin After Roux-en-Y Gastric Bypass Surgery.” Journal of Antimicrobial Chemotherapy 67 (1): 226–229.
APA
De Smet, Julie, Colin, P., De Paepe, P., Ruige, J., Batens, H., Van Nieuwenhove, Y., Vogelaers, D., et al. (2012). Oral bioavailability of moxifloxacin after Roux-en-Y gastric bypass surgery. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 67(1), 226–229.
Vancouver
1.
De Smet J, Colin P, De Paepe P, Ruige J, Batens H, Van Nieuwenhove Y, et al. Oral bioavailability of moxifloxacin after Roux-en-Y gastric bypass surgery. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY. 2012;67(1):226–9.
MLA
De Smet, Julie, Pieter Colin, Peter De Paepe, et al. “Oral Bioavailability of Moxifloxacin After Roux-en-Y Gastric Bypass Surgery.” JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 67.1 (2012): 226–229. Print.