Influence of pharmacokinetics/pharmacodynamics of antibacterials in their dosing regimen selection.
The choice of antimicrobial dosing in clinical practice in the past was based upon a 'penicillin mentality', that is, on the assumption that the in vivo antimicrobial efficacy is dependent on the duration of drug levels above the minimum inhibitory concentration of target microorganisms. Really, a rational antimicrobial therapy is strongly related to a basic understanding of the influence the patient has on the antibiotic (pharmacokinetics [PKs]) and the patient's response to the specific drug effects (pharmacodynamics [PDs]). PK/PD parameters are essential in facilitating the translation of microbiological activity into clinical situations, ensuring a successful outcome. This review will analyze the typical patterns of antimicrobial activity and the corresponding PK/PD parameters, with a special focus on a PK/PD dosing approach with the most commonly utilized antimicrobial agent classes.
Scaglione
Francesco
F
University of Milan, Department of Pharmacology, Chemotherapy and Toxicology, Faculty of Medicine, Via Vanvitelli 32, 20129, Milan, Italy. francesco.scaglione@unimi.it
Paraboni
Luca
L
D000617:Aminoglycosides / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D001424:Bacterial Infections / Q000188:drug therapy*; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D006020:Glycopeptides / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D006801:Humans; D048628:Ketolides / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D018942:Macrolides / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D006020:Glycopeptides; D048628:Ketolides; D018942:Macrolides