title: The importance of bactericidal drugs: future directions in infectious disease.
abstract: 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.
authors.affiliation: University of Massachusetts Medical Center, Worcester, MA 01655, USA. Robert.Finberg@umassmed.edu
authors.forename: Robert W
authors.initials: RW
authors.lastname: Finberg
authors.forename: Robert C
authors.initials: RC
authors.lastname: Moellering
authors.forename: Francis P
authors.initials: FP
authors.lastname: Tally
authors.forename: William A
authors.initials: WA
authors.lastname: Craig
authors.forename: George A
authors.initials: GA
authors.lastname: Pankey
authors.forename: E Patchen
authors.initials: EP
authors.lastname: Dellinger
authors.forename: Michael A
authors.initials: MA
authors.lastname: West
authors.forename: Manjari
authors.initials: M
authors.lastname: Joshi
authors.forename: Peter K
authors.initials: PK
authors.lastname: Linden
authors.forename: Ken V
authors.initials: KV
authors.lastname: Rolston
authors.forename: John C
authors.initials: JC
authors.lastname: Rotschafer
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rybak
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents