Optimisation of antibiotic therapy in cystic fibrosis patients. Pharmacokinetic considerations.
Antibiotic therapy plays a central role in the medical management of patients with cystic fibrosis. While totally convincing efficacy data are lacking, antibiotics probably have a pronounced beneficial effect on both morbidity and mortality. Much has been learned in the past 20 years about antibiotic use in this population. At the same time, new antimicrobial agents with the potential to treat this condition have become available for use. The pharmacokinetics of a number of antibiotic classes, including beta-lactams, aminoglycosides and quinolones, are altered in this patient population. Increased total body clearance is a common occurrence but is not always changed enough to warrant altered dosages. Nonetheless, in light of altered pharmacokinetics in the cystic fibrosis population, appropriate dosage and monitoring parameters for a number of antibiotics have been determined.
Pharmacy Department, Texas Children's Hospital, Houston.
C A
CA
Lindsay
J A
JA
Bosso
D000328:Adult; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D016903:Drug Monitoring; D024841:Fluoroquinolones; D006801:Humans; D007769:Lactams; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000493:pharmacokinetics / Q000627:therapeutic use
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D007769:Lactams; D015662:Trimethoprim, Sulfamethoxazole Drug Combination