The importance of bactericidal drugs: future directions in infectious disease.
BACKGROUND
Although a considerable amount of research has gone into the study of the role of bactericidal versus bacteriostatic antimicrobial agents in the treatment of different infectious diseases, there is no accepted standard of practice.


METHODS
A panel of infectious diseases specialists reviewed the available literature to try to define specific recommendations for clinical practice.


RESULTS
In infections of the central nervous system, the rapidity with which the organism is killed may be an important determinant, because of the serious damage that may occur during these clinical situations. The failure of bacteriostatic antibiotics to adequately treat endocarditis is well documented, both in human studies and in animal models.


CONCLUSIONS
The bulk of the evidence supports the concept that, in treating endocarditis and meningitis, it is important to use antibacterial agents with in vitro bactericidal activity. This conclusion is based on both human and animal data. The data to support bactericidal drugs' superiority to bacteriostatic drugs do not exist for most other clinical situations, and animal models do not support this concept in some situations. Clinicians should be aware that drugs that are bacteriostatic for one organism may in fact be bactericidal for another organism or another strain of the same organism.
Finberg
Robert W
RW
University of Massachusetts Medical Center, Worcester, MA 01655, USA. Robert.Finberg@umassmed.edu
Moellering
Robert C
RC
Tally
Francis P
FP
Craig
William A
WA
Pankey
George A
GA
Dellinger
E Patchen
EP
West
Michael A
MA
Joshi
Manjari
M
Linden
Peter K
PK
Rolston
Ken V
KV
Rotschafer
John C
JC
Rybak
Michael J
MJ
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D001770:Blood Bactericidal Activity; D003141:Communicable Diseases / Q000188:drug therapy*; D006801:Humans
D000900:Anti-Bacterial Agents