Individualising Therapy to Minimize Bacterial Multidrug Resistance
A J Heffernan1,2, F B Sime2,3, J Lipman3,4
1School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
Drugs
|March 24, 2018
Summary
Optimizing antibiotic dosing using pharmacokinetic/pharmacodynamic (PK/PD) measures can limit antibiotic resistance. Biomarkers and combination therapy may also help individualize treatment and suppress resistance emergence.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Antibiotic resistance is a major threat to healthcare.
- Standard antibiotic regimens may fail to prevent resistance.
- Antibiotic dosing is a potential contributing factor.
Purpose of the Study:
- Review the role of PK/PD measures in optimizing antibiotic therapy.
- Minimize antibiotic resistance emergence.
- Describe combination therapy and biomarker utility for resistance suppression and individualized treatment.
Main Methods:
- Searched PubMed and Web of Science for relevant scientific articles.
- Summarized existing evidence on PK/PD, combination therapy, and biomarkers.
- Focused on studies related to antibiotic resistance suppression.
Main Results:
- Optimizing antibiotic dosing to achieve specific PK/PD ratios may limit resistance.
- Specific ratios (e.g., aminoglycoside Cmax/MIC > 20) are suggested for resistance suppression.
- In vitro studies support some antibiotic combinations, but clinical evidence is limited.
Conclusions:
- PK/PD optimization and specific dosing targets show promise for limiting antibiotic resistance.
- Combination therapy and biomarker-guided treatment require further clinical validation.
- Future research should focus on translating in vitro findings to clinical practice for resistance suppression.
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