[Pharmacokinetics and pharmacodynamics of antimicrobial therapy used in child osteoarticular infections].
The progress in the knowledge of antibiotic action mechanisms have led to determine phamacodynamic/pharmacokinetic (PK/PD) parameters predictive of antibiotic efficacy in bacterial infections. According to the antibiotic compound, the implicated bacterial specie, the localization of the infection, the severity of the disease, these parameters could vary. The PK/PD parameters described in this paper focus only on blood compartment and S. aureus, (main bacteria implicated in bone and joint tissue infections). All beta-lactamase resistant beta-lactam compounds given by IV route, if they are prescribed at the good dosage and frequency, fulfill these PK/PD parameters. In contrast, by oral route, M penicillins and cefuroxime-axetil should not be considered as acceptable regimens. Only amoxicillin-clavulanate and some first generation cephalosporin compounds fulfill the PK/PD parameters predictive of clinical efficacy if S. aureus strains are methicillin susceptible and dosages of cephalosporins are increased. Clindamycin is a very interesting alternative, if the strains are susceptible to macrolides.
Cohen
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R
Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, Hôpital Armand-Trousseau, 26 av Docteur Arnold-Netter 75012 Paris, France. robert.cohen@wanadoo.fr
Grimprel
E
E
D000208:Acute Disease; D000284:Administration, Oral; D000367:Age Factors; D000658:Amoxicillin / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology* / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000382:microbiology; D002511:Cephalosporins / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002981:Clindamycin / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D024881:Drug Resistance, Bacterial; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D015201:Meta-Analysis as Topic; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects*; D047090:beta-Lactams / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D047090:beta-Lactams; D002981:Clindamycin; D000658:Amoxicillin; D008712:Methicillin