Pharmacokinetic and pharmacodynamic issues in the treatment of bacterial infectious diseases.
This review outlines some of the many factors a clinician must consider when selecting an antimicrobial dosing regimen for the treatment of infection. Integration of the principles of antimicrobial pharmacology and the pharmacokinetic parameters of an individual patient provides the most comprehensive assessment of the interactions between pathogen, host, and antibiotic. For each class of agent, appreciation of the different approaches to maximize microbial killing will allow for optimal clinical efficacy and reduction in risk of development of resistance while avoiding excessive exposure and minimizing risk of toxicity. Disease states with special considerations for antimicrobial use are reviewed, as are situations in which pathophysiologic changes may alter the pharmacokinetic handling of antimicrobial agents.
McKinnon
P S
PS
Detroit Receiving Hospital, Anti-Infective Research Laboratory and Wayne State University, 4201 St. Antoine Boulevard, 1B-UHC, Detroit, MI 48201, USA. pmckinno@dmc.org
Davis
S L
SL
D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D001682:Biological Availability; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents