The aim of this paper was to investigate the pharmacokinetics (PK) and pharmacodynamics (PD) of nemonoxacin, a novel nonfluorinated quinolone, against Streptococcus pneumoniae in vitro. A modified infection model was used to simulate the pharmacokinetics of nemonoxacin following scaling of single oral doses and multiple oral dosing. Four S. pneumoniae strains with different penicillin sensitivities were selected, and the drug efficacy was quantified by the change in log colony counts within 24 h. A sigmoid maximum-effect (E max ) model was used to analyze the relationship between PK/PD parameters and drug effect. Analysis indicated that the killing pattern of nemonoxacin shows a dualism which is mainly concentration dependent when the MIC is low and that the better PK/PD index should be the area under the concentration-time curve for the free, unbound fraction of the drug divided by the MIC (fAUC 0 -24 /MIC), which means that giving the total daily amount of drug as one dose is appropriate under those conditions. When the MIC is high, the time (T) dependency is important and the valid PK/PD index should be the cumulative percentage of a 24-h period in which the drug concentration exceeds the MIC under steady-state pharmacokinetic conditions (f%T>MIC), which means that to split the maximum daily dose into several separate doses will benefit the eradication of the bacteria. To obtain a 3-log 10 -unit decrease, the target values of fAUC 0 -24 /MIC and f%T>MIC are 47.05 and 53.4%, respectively. N emonoxacin, a novel nonfluorinated quinolone, exerts broad antibacterial activity by interrupting DNA synthesis in prokaryotic organisms (1). The antimicrobial spectrum includes Gram-positive and Gram-negative bacteria as well as atypical pathogens such as penicillin-resistant Streptococcus pneumoniae and methicillin-and vancomycin-resistant Staphylococcus aureus (2, 3). The antibacterial activity of nemonoxacin is stronger than that of levofloxacin and moxifloxacin against most Gram-positive cocci (4).Completed phase I clinical trials in China have demonstrated that nemonoxacin is well tolerated within the dose range of 125 to 1,000 mg and shows linear pharmacokinetics. The absorption peak appeared at 1 to 2 h, and the elimination half-life was 10 to 12 h (5). In a phase II clinical trial, the effect of nemonoxacin (500 or 750 mg daily for 7 to 10 days) was similar to that of 500 mg levofloxacin for treating community-acquired pneumonia (CAP) in adults (6). A phase III clinical trial has just completed. However, few studies have investigated the killing pattern and pharmacokinetic/pharmacodynamic (PK/PD) characteristics of this drug, which are needed for the dose regimen design.Compared to animal models, the PK process of the drug in humans could be well simulated in the in vitro models without considering species differences between human and animals (7, 8). Meanwhile, in vitro models allow determination of time-kill behavior and identification and optimization of PK/PD indices and breakpoints (9). In the present work, we...