title: Optimizing Antibiotic Dosing Strategies for the Treatment of Gram-negative Infections in the Era of Resistance.
abstract: Gram-negative organisms are an increasing source of concern within the healthcare setting due to their common presence as a cause of infection and emerging resistance to current therapies. However, current antimicrobial dosing recommendations may be insufficient for the treatment of gram-negative infections. Applying knowledge of an antibiotic's pharmacokinetic/pharmacodynamic profile when designing a dosing regimen leads to a greater likelihood of achieving optimal exposure, including against gram-negative pathogens with higher MICs. Additionally, administering antibiotics directly to the site of infection, such as via aerosolization for pneumonia, is another method to achieve optimized drug exposure at the site of infection. Incorporating these treatment strategies into clinical practice will assist antimicrobial stewardship programs in successfully treating gram-negative infections.
authors.affiliation: a Center for Anti-Infective Research and Development , Hartford Hospital , Hartford , CT , USA.
authors.forename: Marguerite L
authors.initials: ML
authors.lastname: Monogue
authors.affiliation: a Center for Anti-Infective Research and Development , Hartford Hospital , Hartford , CT , USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Kuti
authors.affiliation: a Center for Anti-Infective Research and Development , Hartford Hospital , Hartford , CT , USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Nicolau
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D004334:Drug Administration Schedule; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents
keywords: Gram-negative bacteria; aerosolized antibiotics; pharmacodynamics; pharmacokinetics; resistance