Practical concept of pharmacokinetics/pharmacodynamics in the management of skin and soft tissue infections

Current Opinion in Infectious Diseases
Federico Pea

Abstract

This article gives an overview of the practical concept of pharmacokinetic/pharmacodynamic principles useful for clinicians in the management of skin and soft tissue infections (SSTIs). Recent studies suggest that distinguishing between bacteriostatic or bactericidal activity when choosing an antimicrobial for the treatment of severe infections could probably be clinically irrelevant. Conversely, what could help clinicians in maximizing the therapeutic efficacy of the various drugs in routine practice is taking care of some pharmacokinetic/pharmacodynamic principles. Concentration-dependent agents may exhibit more rapid bacterial killing than observed with time-dependent agents. Serum concentrations may not always adequately predict tissue exposure in patients with SSTIs, and measuring concentrations at the infection site is preferable. Hydrophilic antimicrobials showed generally lower penetration rates than the lipophilic ones and might require alternative dosing approaches in the presence of severe sepsis or septic shock. Conversely, tissue penetration of lipophilic antimicrobials is often unaffected by the pathophysiological status. Real-time therapeutic drug monitoring may be a very helpful tool for optimizing therapy of se...Continue Reading

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Citations

Jan 25, 2017·Current Opinion in Infectious Diseases·Mordechai Grupper, David P Nicolau
Jan 18, 2018·The New England Journal of Medicine·Adam J SingerRobert S Kirsner
Mar 7, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Milo GattiSergio Arlati
May 29, 2019·Expert Review of Clinical Pharmacology·Nynke G L JagerMenino O Cotta
Feb 19, 2020·Journal of Wound Care·Jan StryjaDeborah Xuereb
Jan 18, 2018·Current Opinion in Infectious Diseases·Carolina Navarro-San FranciscoRafael Cantón
Jan 19, 2018·The New England Journal of Medicine·Adhish Agarwal
Apr 1, 2020·Expert Review of Anti-infective Therapy·Alex SorianoFederico Pea
Jan 13, 2018·Current Opinion in Infectious Diseases·Matteo BassettiElda Righi
Jan 19, 2018·Current Opinion in Infectious Diseases·Emilio BouzaAlmudena Burillo
Aug 17, 2018·The Journal of Antimicrobial Chemotherapy·Zoe OesterreicherMarkus Zeitlinger
Feb 6, 2020·Expert Review of Anti-infective Therapy·Gabriele SgangaFrancesco Menichetti
Apr 14, 2020·Anesthesia and Analgesia·Tiffany S MoonRoman Schumann
Oct 10, 2021·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Sébastien TanakaPhilippe Montravers

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