Table of Contents
Pharmacokinetics / Pharmacodynamics as a mean to improve
the medical prescription of antibiotics
The ideal antibiotic ...
Will it always be ideal ?
Main causes of antibiotic failures... Adapted from
Pechère J.C., 1988, 1993, 1998
Pharmacokinetics / pharmacodynamics as a step towards
an improved therapy...
Pharmacokinetics ...
Pharmacodynamics ...
Ce que veut (et doit obtenir) le clinicien ...
Ce que veut (et doit obtenir) le clinicien ...
Pharmacokinetics / Pharmacodynamics in drug development
and evaluation of efficacy
PK/PD in drug develop-ment A view from FDA
Are PK/PD important for efficacy / toxicity ?
Pharmacokinetic/ Pharmacodynamics and antibiotic
resistance...
Are PK / PD important in resistance ?
PK / PD of antibiotics in 2001 ?
PK / PD for Seminfect ?
PK/PD parameters: a first sight
PK/PD parameters : a 2d sight
Pharmacokinetics / Pharmacodynamics
PK/PD patterns of antimicrobial activity (1 of
3) (after WA. Craig, 2000)
PK/PD patterns of antimicrobial activity (2 of
3) (after WA. Craig, 2000)
PK/PD patterns of antimicrobial activity (3 of
3) (after WA. Craig, 2000)
Pharmacokinetics / Pharmacodynamics in action ...
Aminoglycosides : obtain a peak !
Pharmacokinetics / Pharmacodynamics in action ...
Pharmacokinetics / Pharmacodynamics in action ...
Pharmacokinetics / Pharmacodynamics in action ...
?-lactams : remain at least 50 % of the time above
the MIC...
Typical pharmacokinetics of a model ?-lactam *
Pharmacokinetics / Pharmacodynamics in action ...
Improving ?-lactam efficacy by reducing the interval
Pharmacokinetics / Pharmacodynamics in action ...
Pharmacokinetics / Pharmacodynamics in action ...
Reducing ? - lactams interval: where can we go
?
? - lactams by continuous infusion
Pharmacokinetics / Pharmacodynamics in action ...
PK/PD of fluoroquinolones: role of the 24h-AUC
MIC ciprofloxacin in hospital-acquired pneumonia
AUC / MIC ratio
PPT Slide
PPT Slide
PPT Slide
PPT Slide
Pharmacokinetics / Pharmacodynamics in action ...
Pharmacokinetics / Pharmacodynamics in action ...
24h-AUC / MIC as a tool to determine acceptable
sensitivities to fluoroquinolones (p.o.)
The role of the peak for fluoroquinolones ...
Peak concentrations as a tool to determine acceptable
sensitivities to fluoroquinolones (p.o.)
Combining it all …(Peak and 24h-AUC / MIC) as predictors
of efficacy of FQ ...
Pharmacokinetics / Pharmacodynamics in action ...
But be careful to individual variations
But be careful to individual variations
Pharmacokinetics / Pharmacodynamics in action:
adusting the dose of a FQ for an MIC
Pharmacokinetics / Pharmacodynamics in action ...
Why would you not use low doses ?
Resistance: a global overview...
Mechanisms of resistance to fluoroquinolones
PK/PD and antibiotic efflux pumps...
PK/PD and antibiotic efflux pumps… an example with
RND...
Pharmacokinetics / Pharmacodynamics in action ...
Peak concentrations as a tool to prevent the emergence
of resistance (MPC)
Where are we in 2001 ?
PK / PD: do they help ?
PK / PD: do they help ?
PK / PD: do they help ?
and let us hope we have a bright future... |