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The Pharmacodynamics of β‐Lactams
Abstract
Considerable information on the pharmacodynamics of beta-lactams has accumulated in the past 20 years. In vitro, beta-lactams demonstrate time-dependent killing and variable postantibiotic effects. Animal models have shown that the time for which drug levels exceed the minimum inhibitory concentration (MIC) correlates best with bacterial eradication, and this is now being borne out in human studies. In investigations on osteomyelitis and endocarditis, trough serum inhibitory titers have generally correlated better with cure than have peak titers, and studies that have analyzed outcomes in relation to the MIC for the infecting pathogen have shown decreasing clinical efficacy with increasing MICs. One prospective study has shown that time above MIC correlated better with time to pathogen eradication than did area under the curve. In some continuous-infusion studies, significantly better outcomes were achieved with continuous infusion against susceptible bacteria or for patients with persistent, profound neutropenia. With use of time above MIC as the predictor of efficacy, it is possible to reexamine current dosing schedules critically.
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Cited by
Guilhaumou, R., Benaboud, S., Bennis, Y., Dahyot-Fizelier, C., Dailly, E., Gandia, P., Goutelle, S., Lefeuvre, S., Mongardon, N., Roger, C., et al. (2019) · Critical Care · doi:10.1186/s13054-019-2378-9 · Cited by 543
Augmented Renal Clearance: Implications for Antibacterial Dosing in the Critically Ill
Udy, A. A., Roberts, J. A., Boots, R. J., Paterson, D. L., & Lipman, J. (2010) · Clinical Pharmacokinetics · doi:10.2165/11318140-000000000-00000 · Cited by 377
Recent advances in materials for extended-release antibiotic delivery system
Gao, P., Nie, X., Zou, M., Shi, Y., & Cheng, G. (2011) · The Journal of Antibiotics · doi:10.1038/ja.2011.58 · Cited by 310
Continuous infusion of β-lactam antibiotics in severe infections: a review of its role
Roberts, J. A., Paratz, J., Paratz, E., Krueger, W. A., & Lipman, J. (2007) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2007.02.002 · Cited by 150
Pharmacodynamics: Relation to Antimicrobial Resistance
Rybak, M. J. (2006) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.04.001 · Cited by 120
Metadata
- Authors
- Turnidge, J. D.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-07
- Volume
- 27
- Issue
- 1
- Pages
- 10-22
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2131171455
- Cited by
- 593
- References
- 0
- FWCI
- 7.63
- Type
- journal article
- Language
- en
- Open access
- closed
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- Turnidge, J. D. (1998). The Pharmacodynamics of β‐Lactams. Clinical Infectious Diseases. https://doi.org/10.1086/514622
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