title: Essential characteristics of antibiotics for the treatment of seriously ill patients.
abstract: To realize their full potential for effective therapy in critically ill patients, antimicrobial agents must share three essential characteristics, namely in vivo as well as in vitro effectiveness, lack of toxicity, and reasonable cost. In vitro activity depends on the ability of the antimicrobial agent to reach its microbial target site and to overcome various mechanisms of resistance in the infecting organism. Although there is a general correlation between in vitro effectiveness and in vivo utility, this is not always true. In addition to having in vitro activity against the infecting organism, effective drugs must penetrate to the site of infection and must retain significant activity at that location. Antimicrobial agents ideally should be nontoxic at all dose levels and should not be metabolized to toxic intermediates. Direct toxicity (adverse effects) is often relatively easy to assess, but antimicrobial agents may also produce subtle abnormalities in host defense mechanisms that are more difficult to assess. In addition to the market price of a given antimicrobial agent, one must also consider the cost of monitoring for the treatment of adverse effects.
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy*; D003365:Costs and Cost Analysis; D004352:Drug Resistance, Microbial; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents