title: Breakpoints for extended-spectrum beta-lactamase-producing Enterobacteriacae: pharmacokinetic/pharmacodynamic considerations.
abstract: An understanding of antibacterial pharmacokinetics and pharmacodynamics is central to setting clinical breakpoints. It is important to understand any impact that a resistance mechanism may have on these basic drug properties. With extended-spectrum beta-lactamase (ESBL)-producing strains of Enterobacteriacae, it is known that MIC, and hence T>MIC, for beta-lactams predicts outcome. Therefore, pharmacodynamic modelling can be used to set breakpoints for ESBL-producing bacteria with beta-lactams.
authors.affiliation: Department of Medical Microbiology, Bristol Centre for Antimicrobial Research and Evaluation, University of Bristol and North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, UK. alasdair.macgowan@nbt.nhs.uk
authors.forename: A
authors.initials: A
authors.lastname: MacGowan
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000592:standards; D009010:Monte Carlo Method; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis*; D047090:beta-Lactams / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D001618:beta-Lactamases