Pharmacokinetic and pharmacodynamic aspects of antimicrobial agents for the treatment of uncomplicated urinary tract infections.
Uncomplicated urinary tract infections (UTI) are treated with beta-lactams, co-trimoxazole, quinolones and fosfomycin tromethamine. Due to increasing resistance of causative pathogens, antibiotics should be used by considering their pharmacodynamic and pharmacokinetic characteristics. beta-lactams have time-dependent activity and should not be used once-daily. Co-trimoxazole should be restricted due to increasing chemoresistance. Fluoroquinolones play a primary role in the treatment of serious and complicated infections. Fosfomycin tromethamine is active against most urinary tract pathogens. In vitro time-kill kinetics of fosfomycin against Escherichia coli and Proteus mirabilis showed primarily concentration-dependent activity, with a prolonged post-antibiotic effect (3.4 to 4.7h). Based on these results a single 3g dose of fosfomycin guarantees optimal efficacy against common uropathogens with an AUC(urine)/MIC ratio of 500.
Mazzei
Teresita
T
Department of Pharmacology, University of Florence, Viale Pieraccini 6, 50139 Firenze, Italy. mazzei@ds.unifi.it
Cassetta
Maria Iris
MI
Fallani
Stefania
S
Arrigucci
Silvia
S
Novelli
Andrea
A
D000890:Anti-Infective Agents / Q000493:pharmacokinetics* / Q000494:pharmacology*; D024841:Fluoroquinolones / Q000493:pharmacokinetics / Q000494:pharmacology; D005578:Fosfomycin / Q000493:pharmacokinetics / Q000494:pharmacology; D006801:Humans; D009582:Nitrofurantoin / Q000493:pharmacokinetics / Q000494:pharmacology; D015363:Quinolones / Q000493:pharmacokinetics / Q000494:pharmacology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000493:pharmacokinetics / Q000494:pharmacology; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000378:metabolism*; D047090:beta-Lactams / Q000493:pharmacokinetics / Q000494:pharmacology
D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D015363:Quinolones; D047090:beta-Lactams; D005578:Fosfomycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D009582:Nitrofurantoin