Journal Article

Clinical Implications of Pharmacokinetics and Pharmacodynamics of Fluoroquinolones

Brian Wispelwey

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 41, issue Supplement_2, pages S127-S135
Published in print July 2005 | ISSN: 1058-4838
Published online July 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/428053
Clinical Implications of Pharmacokinetics and Pharmacodynamics of Fluoroquinolones

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This review summarizes key data illustrating the clinical importance of pharmacodynamics, particularly among the fluoroquinolone family of antibacterials. Antibacterials are often divided into 2 groups—either time-dependent or concentration-dependent agents—on the basis of their mechanism of killing. Fluoroquinolones are concentration-dependent agents, and the parameter that correlates most closely with clinical and/or bacteriological success is the ratio of the area under plasma concentration curve (AUC) to the minimum inhibitory concentration (MIC). The AUC : MIC threshold may vary by organism. For example, a ratio of at least 30 is often cited as optimal to achieve success against Streptococcus pneumoniae, whereas higher ratios (>100) are considered to be optimal for the treatment of infections due to gram-negative bacilli. Data are cited to suggest that the minimum ratio necessary to prevent the selection of resistant mutants may, in fact, be somewhat higher. Maximizing the AUC : MIC through the use of potent therapy may offer an opportunity to limit the development of resistance to fluoroquinolones.

Journal Article.  6837 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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