Optimizing clinical outcomes by the use of pharmokinetic and pharmacodynamic principles

Since the advent of antimicrobial chemotherapy, considerable controversy has existed as to the most appropriate method to administer antibiotics to maximize the killing of microorganisms, while minimizing toxicity to the patient. Over the past decade, data gained from animal models of infection, in vitro pharmacodynamic studies, volunteer studies and human clinical trials have enabled us to establish the best mode of drug administration to achieve these goals. The clinician should be aware that appropriate antibiotic selection and dosing depends on pharmacodynamic concepts where there is an integration of the drug's microbiological activity, pharmacokinetic properties and mode of bacterial killing.