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

Mouton, Johan W
Ambrose, Paul G
Canton, Rafael
Drusano, George L
MacGowan, Alasdair
Theuretzbacher, Ursula
Turnidge, John
Published in Drug resistance updates. 2011, vol. 14, no. 2, p. 107-17
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 AnimalsAnti-Bacterial Agents/pharmacokinetics/therapeutic useArea Under CurveBacterial Infections/drug therapy/microbiologyDose-Response Relationship, DrugDrug Administration ScheduleDrug Dosage CalculationsDrug Resistance, Bacterial/drug effectsGram-Negative Bacteria/drug effects/growth & developmentGram-Positive Bacteria/drug effects/growth & developmentHumansMiceMicrobial Sensitivity Tests/methodsModels, BiologicalRats
PMID: 21440486
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Research group Epidémiologie et contrôle de la résistance aux antibiotiques (866)
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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. 107-17. doi: 10.1016/j.drup.2011.02.005 https://archive-ouverte.unige.ch/unige:25489

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Deposited on : 2013-01-14

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