title: Pharmacogenomics of antimicrobial agents.
abstract: Antimicrobial efficacy and toxicity varies between individuals owing to multiple factors. Genetic variants that affect drug-metabolizing enzymes may influence antimicrobial pharmacokinetics and pharmacodynamics, thereby determining efficacy and/or toxicity. In addition, many severe immune-mediated reactions have been associated with HLA class I and class II genes. In the last two decades, understanding of pharmacogenomic factors that influence antimicrobial efficacy and toxicity has rapidly evolved, leading to translational success such as the routine use of HLA-B*57:01 screening to prevent abacavir hypersensitivity reactions. This article examines recent advances in the field of antimicrobial pharmacogenomics that potentially affect treatment efficacy and toxicity, and challenges that exist between pharmacogenomic discovery and translation into clinical use.
authors.affiliation: Department of General Medicine & Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Ar Kar
authors.initials: AK
authors.lastname: Aung
authors.forename: David W
authors.initials: DW
authors.lastname: Haas
authors.forename: Todd
authors.initials: T
authors.lastname: Hulgan
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Phillips
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000235:genetics*; D014644:Genetic Variation; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D010597:Pharmacogenetics; D000099227:Abacavir
chemical_list: D000890:Anti-Infective Agents; D015224:Dideoxynucleosides; D015235:HLA-B Antigens; D000099227:Abacavir; C103707:HLA-B57 antigen
keywords: antibacterials; antifungals; antimalarials; antivirals; pharmacogenomics