en
Scientific article
Meta-analysis
English

Conserving antibiotics for the future: new ways to use old and new drugs from a pharmacokinetic and pharmacodynamic perspective

Published inDrug resistance updates, vol. 14, no. 2, p. 107-117
Publication date2011
Abstract

There is a growing need to optimize the use of old and new antibiotics to treat serious as well as less serious infections. The topic of how to use pharmacokinetic and pharmacodynamic (PK/PD) knowledge to conserve antibiotics for the future was elaborated on in a workshop of the conference (The conference "The Global Need for Effective Antibiotics - moving towards concerted action", ReAct, Uppsala, Sweden, 2010). The optimization of dosing regimens is accomplished by choosing the dose and schedule that results in the antimicrobial exposure that will achieve the microbiological and clinical outcome desired while simultaneously suppressing emergence of resistance. PK/PD of antimicrobial agents describe how the therapeutic drug effect is dependent on the potency of a drug against a microorganism and the exposure (the concentration of antimicrobial available for effect over time). The description and modeling of these relationships quantitatively then allow for a rational approach to dose optimization and several strategies to that purpose are described. These strategies include not only the dosing regimen itself but also the duration of therapy, preventing collateral damage through inappropriate use and the application of PK/PD in drug development. Furthermore, PK/PD relationships of older antibiotics need to be urgently established. The need for global harmonization of breakpoints is also suggested and would add efficacy to antibiotic therapy. For each of the strategies, a number of priority actions are provided.

Keywords
  • Animals
  • Anti-Bacterial Agents/pharmacokinetics/therapeutic use
  • Area Under Curve
  • Bacterial Infections/drug therapy/microbiology
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Dosage Calculations
  • Drug Resistance, Bacterial/drug effects
  • Gram-Negative Bacteria/drug effects/growth & development
  • Gram-Positive Bacteria/drug effects/growth & development
  • Humans
  • Mice
  • Microbial Sensitivity Tests/methods
  • Models, Biological
  • Rats
Citation (ISO format)
MOUTON, Johan W et al. Conserving antibiotics for the future: new ways to use old and new drugs from a pharmacokinetic and pharmacodynamic perspective. In: Drug resistance updates, 2011, vol. 14, n° 2, p. 107–117. doi: 10.1016/j.drup.2011.02.005
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Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1368-7646
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