Pharmacokinetics, microbiology, cost: interrelated problems for the 1990s that impact on the use of fluoroquinolone...

Correlation of pharmacokinetic and pharmacodynamic properties of antimicrobial agents with in vitro activity is critical to proper use of antibiotics. Knowledge of minimal inhibitory concentrations (MICs) and minimal bactericidal concentrations (MBCs) is essential for life-threatening infections and has increased relevance with regard to development of resistance when treating selected urinary tract and wound infections. Factors that decrease absorption of oral agents profoundly affect clinical efficacy. The dose and frequency of dosing programs of the new oral fluoroquinolones should be correlated with the body site of infection, the organism being treated, and the propensity of the organism to become resistant. The long elimination half-life and high urine concentrations of newer fluoroquinolones permit once-daily therapy in many infections.