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[Plasma and tissue antibiotic concentrations: what is their prognostic value?]
1Dipartimento di Farmacologia Preclinica e Clinica, Università degli Studi di Firenze.
Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna
|July 1, 1992
Summary
Antimicrobial drug concentrations in tissues are crucial for treating infections. Blood levels predict efficacy for some drugs, but not all, necessitating tissue-specific pharmacokinetic studies for optimal treatment.
Area of Science:
- Pharmacology
- Infectious Diseases
- Drug Development
Context:
- Pharmacokinetic studies are essential for antimicrobial agents, as infections often occur outside the bloodstream.
- Analyzing tissue distribution presents challenges due to variability in methods, drug types, and tissue characteristics.
Purpose:
- To evaluate the predictive value of traditional pharmacokinetic models for newer antimicrobial agents.
- To highlight the importance of determining drug concentrations in specific tissue compartments, especially those with penetration barriers.
Summary:
- Drug concentrations in tissues without barriers are predictable from blood levels for many antimicrobials (e.g., beta-lactams, quinolones, macrolides).
- For intracellularly acting drugs like azithromycin, blood levels do not correlate with therapeutic concentrations at the infection site.
- Determining drug concentrations in barrier tissues (CNS, eyes, bronchial secretions) is vital for new antimicrobial agents, considering dosage and tissue pathology.
Impact:
- Re-evaluation of the "chemotherapeutic formula" is needed, as it may not accurately predict efficacy for all newer antimicrobials.
- Improved understanding of antimicrobial pharmacokinetics in various tissues can lead to more effective treatment strategies.
- This research informs the development and clinical application of novel antimicrobial therapies.