Antimicrobial pharmacokinetics

This wide range of pharmacokinetic properties, along with thek ease of administration, broad spectmm antimicrobial activity, and noninterference with host-defense mechanisms is responsible for thek widespread use five decades after thek discovery. 

Antimicrobial action peculiarities and pharmacokinetics of novel fluoroquinolones 98MI6. 

Drug-specific considerations in antimicrobial selection include the spectrum of activity, effects on nontargeted microbial flora, appropriate dose, pharmacokinetic and pharmacodynamic properties, adverse-effect and drug-interaction profile, and cost. 

Brogden RN, Peters DH Teicoplanin A reappraisal of its antimicrobial activity, pharmacokinetic properties and therapeutic efficacy. Drugs 1994 47 823-854. 

Gillum JG, Israel DS, Polk RE Pharmacokinetic drug interactions with antimicrobial agents. Clin Pharmacokinet 1993,25 450-482. 

Integration of both pharmacokinetic and pharmacodynamic properties of an agent is important when choosing antimicrobial therapy to ensure efficacy and prevent resistance. Antibiotics may demonstrate concentration-dependent (aminoglycosides and fluoroquinolones) or time-depen-dent (/l-1 acta ms) bactericidal effects. 

The use of antimicrobials for this purpose requires consideration of the types of patients who are at risk the procedures causing bacteremia the organisms that are likely to cause endocarditis and the pharmacokinetics, spectrum, cost, and ease of administration of available agents. The objective... 

Rajagopalan P, Wudl F, Schinazi RF, Boudinot FD (1996) Pharmacokinetics of a water-soluble fullerene in rats. Antimicrobial Agents and Chemotherapy 40 2262-2265. 

It appears that qualitative correlations between antibacterial activity and rate constants of HO ion catalyzed hydrolysis are fortuitous since many factors other than transpeptidase acylation contribute to antimicrobial activity. These other contributing factors include permeation of the outer membrane of the bacterial cell wall, resistance to /3-lactamase, the fit in the active site of the enzyme, stability of the acylated enzyme, and, last but not least, in vivo pharmacokinetic behavior. 

Dowell JA, Stogniew M, Krause D, Henkel T. (2003) Anidulafungin (ANID) pharmacokinetic (PK)/Pharmacodynamic (PD) correlation Treatment of esophageal candidiasis. 43rd Interscience Conference of Antimicrobial Agents and Chemotherapy Abstract A-1578. 

Despite the few differences in these dmgs in terms of pharmacokinetic features, then-broad spectrum of antimicrobial action is similar in many regards. 

Andes, D., Marchillo, K., Stamstad, T. and Conklin, R. (2003) vivo pharmacokinetics and pharmacodynamics of a new triazole, voriconazole, in a murine candidiasis model. Antimicrobial Agents and Chemotherapy, 47, 3165-3169. 

Pharmacokinetic parameters are also important in relation to toxicity. The toxicity of antimicrobial drugs varies considerably and is usually concentration dependent. The therapeutic index is the ratio between the concentration of drug that is toxic for the... 

For parenteral therapy, nafciUin and oxacillin offer comparable efficacy and antimicrobial spectra of activity. Although both drugs undergo hepatic metabolism, only nafcillin requires dose adjustment in patients with combined hepatic and renal insufficiency. Other pharmacokinetic data for nafcillin and oxacillin appear in Table 45.1. Indications for nafcillin or oxacillin include severe staphylococcal infections like cellulitis, empyema, endocarditis, osteomyelitis, pneumonia, septic arthritis, and toxic shock syndrome. 

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