Pkpd And Hospital Treatment Guidelinesalgorithms

Pharmacokinetic and pharmacodynamic principles play an important role in the evaluation and selection of antimicrobial therapy for treatment guidelines (13,14,16). PK-PD analyses have been particularly useful for the development of guidelines for the treatment of infections for which antimicrobial resistance has recently emerged. Recent guidelines for anti-bacterial therapy for the respiratory tract have relied heavily on PK-PD concepts.

Similar to the modeling process described above, first the PK-PD measure that best predicts antimicrobial activity in vivo for the drug classes under consideration is identified. Next, the magnitude of the PK-PD parameter required for efficacy is determined (i.e., PK-PD target) for each drug-organism combination, and resistance may be defined for situations in which the PK-PD goal cannot be achieved. Subsequently, data from population pharmacokinetics and large in vitro susceptibility surveillance projects may be considered in the context of the PK-PD target. Finally, the likelihood of treatment success in the empiric therapy of the infection for each of the drugs can be determined. The most detailed prediction analysis has been undertaken by the Sinus and Allergy Health Partnership (16) for the development of appropriate antibacterial therapies for bacterial sinusitis and otitis media.

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