Once-a-day cephalosporins: reality or myth?
The factors that may influence the pharmacodynamics of antimicrobial agents against microorganisms at the site of infection must be considered before using once-daily antimicrobial chemotherapy in clinical practice. From a pharmacokinetic point of view, we can establish which antibiotic is suitable for once-daily therapy. For aminoglycosides and quinolones, where the bacterial killing is rapid and dose dependent, and there is a post-antibiotic effect (PAE), the pharmacodynamic objective is to maintain the tissue levels way above the minimum inhibitory concentration (MIC) for a short period. This can be achieved by giving single bolus doses at long time intervals. With beta-lactam antibiotics, however, which have a slow time-dependent antibacterial effect and do not display a PAE, the aim is to keep the antibiotic concentration above the MIC for the duration of therapy.
Scaglione
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F
Department of Pharmacology, University of Milan, Italy.
Dugnani
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S
Fraschini
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F
D002511:Cephalosporins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004334:Drug Administration Schedule; D006801:Humans; D008826:Microbial Sensitivity Tests
D002511:Cephalosporins