Antimicrobial drug resistance.
This chapter provides an overview of our current understanding of the mechanisms associated with the development of antimicrobial drug resistance, international differences in definitions of resistance, ongoing efforts to track shifts in drug susceptibility, and factors that can influence the selection of therapeutic intervention. The latter presents a matrix of complex variables that includes the mechanism of drug action, the pharmacokinetics (PK) of the antimicrobial agent in the targeted patient population, the pharmacodynamics (PD) of the bacterial response to the antimicrobial agent, the PK/PD relationship that will influence dose selection, and the integrity of the host immune system. Finally, the differences between bacterial tolerance and bacterial resistance are considered, and the potential for non-traditional anti-infective therapies is discussed.
Martinez
Marilyn
M
Office of New Animal Drug Evaluation (HFV-130), Center for Veterinary Medicine Food and Drug Administration, 7500 Standish Place, Rockville, MD 20855, USA. marilyn.martinez@fda.hhs.gov
Silley
Peter
P
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000145:classification / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects / Q000235:genetics; D001424:Bacterial Infections / Q000188:drug therapy / Q000662:veterinary; D034301:Deinococcus / Q000187:drug effects / Q000528:radiation effects; D016903:Drug Monitoring / Q000379:methods; D004351:Drug Resistance; D004352:Drug Resistance, Microbial / Q000502:physiology*; D004361:Drug Tolerance; D020022:Genetic Predisposition to Disease; D009154:Mutation; D013997:Time Factors; D014730:Veterinary Medicine / Q000379:methods; D014774:Virulence
D000900:Anti-Bacterial Agents