The pharmacodynamics of an antimicrobial drug relates its pharmacokinetics to the time course of the antimicrobial effects at the site of the infection. Knowledge of the drug's antimicrobial pharmacodynamic effects eg, rate and extent of bactericidal action and postantibiotic effect provides a more rational basis for determination of optimal dosing regimens in terms of the dose and the dosing interval than do the minimal inhibitory concentrations MICs and minimal bactericidal concentrations MBCs determined in vitro. This article reviews pharmacokinetics, antimicrobial pharmacodynamics, the effect of pharmacodynamics on the emergence of resistant bacterial subpopulations, and the development of pharmacodynamic breakpoints for use in the design of trials of these drugs and in the treatment of infected patients. Despite acknowledged exceptions with certain drug—bacteria combinations, antibacterial drugs are usually divided into two groups: those that are primarily bacteriostatic ie, that inhibit growth of the organism and those that are primarily bactericidal ie, that kill the organism. Bacteriostatic drugs require the aid of host defenses to clear tissues of the infecting microorganism; if the host defenses are systemically inadequate eg, agranulocytosis or the host defenses are impaired locally at the site of infection eg, cardiac vegetation in left-sided endocarditis, cerebrospinal fluid in meningitis , the pathogen will resume growth after stopping the bacteriostatic drug, and the infection will relapse. Bacterial infection in these circumstances will require the use of bactericidal drugs.
Pharmacokinetics and Pharmacodynamics of Antibacterial Agents
Why VIBATIV® (telavancin)
Antibiotics in the ICU are in some ways simpler than antibiotic therapy for less ill patients. IV access isn't an issue. Patients are critically ill, so we're justified in using broad-spectrum agents initially. There is considerable variation in this between different hospitals, so when in doubt consider your local antibiogram and consult with pharmacists and infectious disease specialists.
The CDC recommends an antibiotic time-out after 48 hours on an initial therapy. Watch the MOA video. Once-daily dosing with no therapeutic drug-level monitoring required 6.
Complicated skin and soft tissue infections cSSTIs represent the severe form of infectious disease that involves deeper soft tissues. Various international guidelines provide recommendations on the management of cSSTIs, with the inclusion of newer antibiotics. This literature-based review discusses the overall management of cSSTI, including appropriate use of antibiotics in clinical practice. Successful treatment of cSSTIs starts with early and precise diagnosis, including identification of causative pathogen and its load, determination of infection severity, associated complications, and risk factors. The current standard-of-care for cSSTIs involves incision, drainage, surgical debridement, broad-spectrum antibiotic therapy, and supportive care.