caa a22 4500 397592566 CHVBK 20180308164943.0 cr unu---uuuuu 161202e199607 xx s 000 0 eng 10.1093/jac/38.suppl_A.141 doi (NATIONALLICENCE)oxford-10.1093/jac/38.suppl_A.141 Relevance of the Alexander Project: Pharmacodynamic considerations [Elektronische Daten] [G. L. Drusano, F. W. Goldstein] Application of pharmacodynamic principles for interpretation of data generated by the Alexander Project is possible for β-lactam, quinolone and macrolide antibiotics. For β-lactams, the time that serum concentrations remain above the MIC of the pathogen (T > MIC) is the parameter most closely linked with outcome. It has been shown that T > MIC need be only 50-60% of a dose interval. Since the MIC has the greatest influence on this parameter, a conservative estimate of activity would use the MICV The only β-lactam antibiotics in the Alexander Project for which T > MIC90 for the four major pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus) exceeded 50% of the dose interval were amoxycillin/clavulanate (500/125 mg) and ceftriaxone. For macrolides, T > MIC is relevant for erythromycin and clarithromycin, but not azithromycin, for which AUC is the parameter most closely linked to outcome. Erythromycin, clarithromycin and azithromycin showed efficacy against M. catarrhalis only at MICV Quinolones (ciprofloxacin and ofloxacin), for which AUC is also the relevant phannacodynamic parameter, had the greatest activity against H. influenzae and M. catarrhalis at MIC90, but were less effective against S. pneumoniae and S. aureus. Susceptibility data such as those provided by the Alexander Project can aid clinicians in choosing appropriate treatment for LRTI based on pharmacodynamic principles. © 1996 The British Society for Antimicrobial Chemotherapy Articles nationallicence Drusano G. L. Division of Clinical Pharmacology, Albany Medical College 47 New Scotland Avenue, Albany, NY 12208, USA aut Goldstein F. W. Laboratoire de Microbiologie Medicale, Hôpital Saint-Joseph 185 rue Raymond Losserand, 75674 Paris Cedex 14, France aut Journal of Antimicrobial Chemotherapy Oxford University Press 38(1996-07), 141-154 0305-7453 38<141 1996 38 jac https://doi.org/10.1093/jac/38.suppl_A.141 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jac/38.suppl_A.141 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Drusano G. L. Division of Clinical Pharmacology, Albany Medical College 47 New Scotland Avenue, Albany, NY 12208, USA aut NATIONALLICENCE 700 1- Goldstein F. W. Laboratoire de Microbiologie Medicale, Hôpital Saint-Joseph 185 rue Raymond Losserand, 75674 Paris Cedex 14, France aut NATIONALLICENCE 773 0- Journal of Antimicrobial Chemotherapy Oxford University Press 38(1996-07), 141-154 0305-7453 38<141 1996 38 jac Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford