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Antibiotic Dosing—Does One Size Fit All?
Jerome J. Schentag, PharmD
JAMA. 1998;279:159-160.
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In this issue of THE JOURNAL, Preston and colleagues1 argue that pharmacokinetic and pharmacodynamic modeling applied prospectively to a clinical trial of a fluoroquinolone antibiotic aids in understanding the efficacy and safety of therapy. The investigators used modeling to link bacterial eradication to the individual minimum inhibitory concentration (MIC) values of the bacteria, and the individual serum concentrations (ie, peak concentration or the area under the curve [AUC]) of the antibiotic in the treated patient. The article presents considerable evidence that the prospective use of these modeling methods in the course of a multicenter antibiotic trial can identify a dose that will ensure efficacy and can predict when a regimen will not work or will select resistant subpopulations of organisms.
The modeling methods and techniques appear complex, and their output consists of complicated graphs and charts. There are few practitioners of this craft, and finding experts . . . [Full Text of this Article]
From the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, NY.
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