title: [Pharmacokinetic/pharmacodynamic analysis in microbiology: a tool for the evaluation of the antimicrobial treatment].
abstract: The selection of multiresistant microorganisms, as a side-effect of the use of antimicrobials, together with the lack of new therapeutic drugs expected in the near future, forces to a rational use of antibiotics. The optimisation of antibacterial treatments based on pharmacokinetic/pharmacodynamic analysis (PK/PD) may contribute to prolong the life of antibiotics and to contain the bacterial resistance to them. A review is made of the importance of the appropriateness of the dose regimen selected, the application of PK/PD analysis of antimicrobials, the Monte Carlo simulation, PK/PD indices for efficacy, and PK/PD cut-off points. PK/PD analysis is also applicable to the prevention of bacterial resistance. Different methods have been used to study the factors that lead to its emergence and spread, such as in vitro and animal models, and resistance prevention studies (mutant selection window). Although the PK/PD analysis is a very useful tool for the selection of the most appropriate dose regimen of antibiotics, several problems limit its use in clinical practice.
authors.affiliation: Servicio de Microbiología, Hospital Universitario de Álava, Instituto de Investigación Biosanitaria, BioAraba, Vitoria-Gasteiz, España. Electronic address: andres.canutblasco@osakidetza.net.
authors.forename: Andrés
authors.initials: A
authors.lastname: Canut Blasco
authors.affiliation: Departamento de Microbiología, Facultad de Medicina, Universidad Complutense, Madrid, España.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Aguilar Alfaro
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Cobo Reinoso
authors.affiliation: Departamento de Microbiología, Facultad de Medicina, Universidad Complutense, Madrid, España.
authors.forename: M José
authors.initials: MJ
authors.lastname: Giménez Mestre
authors.affiliation: Grupo de Farmacocinética, Nanotecnología y Terapia Génica, Facultad de Farmacia, Centro de Investigación Lascaray ikergunea, Universidad del País Vasco UPV/EHU, Vitoria-Gasteiz, España.
authors.forename: Alicia
authors.initials: A
authors.lastname: Rodríguez-Gascón
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects / Q000235:genetics; D002986:Clinical Trials as Topic; D003198:Computer Simulation; D004305:Dose-Response Relationship, Drug; D004353:Drug Evaluation, Preclinical; D004352:Drug Resistance, Microbial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*; D023421:Models, Animal; D008954:Models, Biological; D009010:Monte Carlo Method; D064887:Observational Studies as Topic; D012641:Selection, Genetic
chemical_list: D000900:Anti-Bacterial Agents
keywords: Análisis farmacocinético/farmacodinámico; Monte Carlo simulation; Mutant selection window; Pharmacokinetic/pharmacodynamic analysis; Pharmacokinetic/pharmacodynamic indices; Simulación de Montecarlo; Ventana de selección de mutantes; Índices de eficacia farmacocinética/farmacodinámica