Interethnic differences in pharmacokinetics of antibacterials
Danny Tsai1, Janattul-Ain Jamal, Joshua S Davis
1Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Level 3, Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD, 4029, Australia.
Clinical Pharmacokinetics
|November 12, 2014
Summary
Interethnic pharmacokinetic differences in antibacterial drug exposure exist, particularly for certain drug classes. Further research is needed to understand the clinical relevance of these variations in drug dosing.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Drug Metabolism and Pharmacokinetics
Background:
- Optimal antibacterial dosing is crucial for patient outcomes.
- Pharmacokinetics of antibacterials can be altered by acute illness and patient-specific factors.
- Interethnic pharmacokinetic differences are not well-understood, complicating dosing regimens.
Purpose of the Study:
- To systematically review and describe pharmacokinetic differences of antibacterials between ethnic groups.
- To explore the probable mechanisms underlying these interethnic variations.
- To discuss the potential clinical implications of these pharmacokinetic differences.
Main Methods:
- A structured literature review was conducted.
- Searched for studies comparing antibacterial pharmacokinetics across different ethnicities.
- Included 50 articles meeting inclusion criteria, with six directly comparing ethnicities.
Main Results:
- Limited evidence found for interethnic pharmacokinetic differences in antibacterials.
- Differences are negligible for carbapenems, most β-lactams, aminoglycosides, glycopeptides, most fluoroquinolones, linezolid, and daptomycin.
- Significant differences observed for ciprofloxacin, macrolides, clindamycin, tinidazole, and some cephalosporins, with up to 2-3 fold higher exposure in Asian vs. Caucasian populations due to lower Vd/CL.
Conclusions:
- Interethnic pharmacokinetic differences in antibacterials are probable.
- The clinical relevance of these observed differences remains unknown.
- Further research is warranted to investigate the clinical significance of these findings.
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