Journal
CLINICAL INFECTIOUS DISEASES
Volume 41, Issue -, Pages S127-S135Publisher
OXFORD UNIV PRESS INC
DOI: 10.1086/428053
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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.
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