Antimicrobial agents/drugs therapeutic concentrations

For most antimicrobial agents, the relation between dose and therapeutic outcome is well established, and serum concentration monitoring is unnecessary for these drugs. To justify routine serum concentration monitoring, it should be established (1) that a direct relationship exists between drug concentrations and efficacy or toxicity (2) that substantial interpatient variability exists in serum concentrations on standard doses (3) that a small difference exists between therapeutic and toxic serum concentrations (4) that the clinical efficacy or toxicity of the drug is delayed or difficult to measure and (5) that an accurate assay is available. 

The maximum plasma concentration reflects the extent of drug bioavailability. It can be used in relation to minimum inhibitory concentration (MIC) to predict the efficacy of concentration-dependent antimicrobial agents (e.g. fluoroquinolones, aminoglycosides). Both the maximum (peak) and minimum (trough) plasma concentrations are used during therapeutic drug monitoring to maximize efficacy and minimize the occurrence of undesirable effects. 

Cetylpyridinium chloride is a quaternary ammonium cationic surfactant, used in pharmaceutical and cosmetic formulations as an antimicrobial preservative see Section 10. It is used therapeutically as an antiseptic agent used alone or in combination with other drugs for oral and throat care used in nonparenteral formulations licensed in the UK and used in oral and inhalation preparations at concentrations of 0.02-1.5 mg (see Section 16). 

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