Abstract:

Inappropriate dosing of antibiotics used in the treatment of infectious diseases leads to the emergence of bacterial resistance which in turn, gives rise to the development of new infections with these resistant bacteria. This issue constitutes the major problem in the treatment of infectious diseases. The recognition and co-evaluation of the principles of pharmacodynamics (PD) and pharmacokinetics (PK) determining the treatment response to antimicrobial therapy provides the proper arrangement of the dosing regimes used in the treatment. The three widespreadly used PD/PK parameters for the prediction of antibiotic effectiveness are: (1) the ratio of maximum serum concentration (Cmax) to minimum inhibitory conncentration (MIC) (Cmax/MIC), (2) the ratio of the area under the plasma concentration versus time curve (AUC) to MIC (AUC/MIC), and (3) the duration of the dosing interval that plasma concentrations exceed the MIC value (T>MIC). According to the PD/PK approach, antibiotics are classified as; 1) concentration-dependent (aminoglycosides, flu- oroquinolones, etc.2) time-dependent (beta-lactams, glycopeptides, etc.and It is demonstrated that the antibiotics in the first group act better when the daily dose is given at a single dose, while the antibiotics in the second group act better when the daily dose is given in divided doses. The determination of dosing regimens by the way of PD/PK approach instead of the MIC value only, has been considered recently in the treatment modalities since it enables successful eradication of bacteria, reduces toxicity, alleviates the likelihood of the generation of resistant strains and consequently increases the clinical success rate. In this review, clinical implications of antibiotic use according to PK/PD principles in the treatment-ment of infectious diseases have been discussed.

Keywords: