title: Practical concept of pharmacokinetics/pharmacodynamics in the management of skin and soft tissue infections.
abstract: OBJECTIVE
  This article gives an overview of the practical concept of pharmacokinetic/pharmacodynamic principles useful for clinicians in the management of skin and soft tissue infections (SSTIs).
  
  
  RESULTS
  Recent studies suggest that distinguishing between bacteriostatic or bactericidal activity when choosing an antimicrobial for the treatment of severe infections could probably be clinically irrelevant. Conversely, what could help clinicians in maximizing the therapeutic efficacy of the various drugs in routine practice is taking care of some pharmacokinetic/pharmacodynamic principles. Concentration-dependent agents may exhibit more rapid bacterial killing than observed with time-dependent agents. Serum concentrations may not always adequately predict tissue exposure in patients with SSTIs, and measuring concentrations at the infection site is preferable. Hydrophilic antimicrobials showed generally lower penetration rates than the lipophilic ones and might require alternative dosing approaches in the presence of severe sepsis or septic shock. Conversely, tissue penetration of lipophilic antimicrobials is often unaffected by the pathophysiological status. Real-time therapeutic drug monitoring may be a very helpful tool for optimizing therapy of severe infections.
  
  
  CONCLUSIONS
  Taking care of pharmacokinetic/pharmacodynamic principles deriving from the most recent findings may help clinicians in maximizing treatment of SSTIs with antimicrobials in every situation.
authors.affiliation: aInstitute of Clinical Pharmacology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia bDepartment of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Pea
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology*; D019468:Disease Management; D016903:Drug Monitoring; D006801:Humans; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D018461:Soft Tissue Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents