Antimicrobial Pharmacodynamics in Theory and Clinical Practice - C. Nightingale, et al., (M-D, 2002) WW

427 Pages·2002·5.59 MB·English

Marcel Dekker, Inc.
New York • Basel

TM

edited by

Charles H. Nightingale

Hartford Hospital
Hartford, Connecticut

Antimicrobial
Pharmacodynamics
in Theory and
Clinical Practice

Takeo Murakawa

Fujisawa Pharmaceutical Company, Ltd.
Osaka, Japan

Paul G. Ambrose

Cognigen Corporation
Buffalo, New York

Copyright © 2001 by Marcel Dekker, Inc. All Rights Reserved.

ISBN: 0-8247-0561-0

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INFECTIOUS DISEASE AND THERAPY

Series Editor

Burke A. Cunha

Winthrop-University Hospital
Mineola, and
State University of New York School of Medicine
Stony Brook, New York

1. Parasitic Infections in the Compromised Host, edited by Peter D.
Walzer and Robert M. Genta
2. Nucleic Acid and Monoclonal Antibody Probes: Applications in
Diagnostic Methodology, edited by Bala Swaminathan and Gyan
Prakash
3. Opportunistic Infections in Patients with the Acquired Immuno-
deficiency Syndrome, edited by Gifford Leoung and John Mills
4. Acyclovir Therapy for Herpesvirus Infections, edited by David A.
Baker
5. The New Generation of Quinolones, edited by Clifford Siporin, Carl L.
Heifetz, and John M. Domagala
6. Methicillin-Resistant Staphylococcus aureus: Clinical Management
and Laboratory Aspects, edited by Mary T. Cafferkey
7. Hepatitis B Vaccines in Clinical Practice, edited by Ronald W. Ellis
8. The New Macrolides, Azalides, and Streptogramins: Pharmacology
and Clinical Applications, edited by Harold C. Neu, Lowell S. Young,
and Stephen H. Zinner
9. Antimicrobial Therapy in the Elderly Patient, edited by Thomas T.
Yoshikawa and Dean C. Norman
10. Viral Infections of the Gastrointestinal Tract: Second Edition, Revised
and Expanded, edited by Albert Z. Kapikian
11. Development and Clinical Uses of Haemophilus b Conjugate Vac-
cines, edited by Ronald W. Ellis and Dan M. Granoff
12. Pseudomonas aeruginosa Infections and Treatment, edited by
Aldona L. Baltch and Raymond P. Smith
13. Herpesvirus Infections, edited by Ronald Glaser and James F. Jones
14. Chronic Fatigue Syndrome, edited by Stephen E. Straus
15. Immunotherapy of Infections, edited by K. Noel Masihi
16. Diagnosis and Management of Bone Infections, edited by Luis E.
Jauregui
17. Drug Transport in Antimicrobial and Anticancer Chemotherapy,
edited by Nafsika H. Georgopapadakou

18. New Macrolides, Azalides, and Streptogramins in Clinical Practice,
edited by Harold C. Neu, Lowell S. Young, Stephen H. Zinner, and
Jacques F. Acar
19. Novel Therapeutic Strategies in the Treatment of Sepsis, edited by
David C. Morrison and John L. Ryan
20. Catheter-Related Infections, edited by Harald Seifert, Bernd Jansen,
and Barry M. Farr
21. Expanding
Indications
for
the
New
Macrolides, Azalides, and
Streptogramins, edited by Stephen H. Zinner, Lowell S. Young,
Jacques F. Acar, and Harold C. Neu
22. Infectious Diseases in Critical Care Medicine, edited by Burke A.
Cunha
23. New Considerations for Macrolides, Azalides, Streptogramins, and
Ketolides, edited by Stephen H. Zinner, Lowell S. Young, Jacques F.
Acar, and Carmen Ortiz-Neu
24. Tickborne Infectious Diseases: Diagnosis and Management, edited
by Burke A. Cunha
25. Protease Inhibitors in AIDS Therapy, edited by Richard C. Ogden
and Charles W. Flexner
26. Laboratory Diagnosis of Bacterial Infections, edited by Nevio Cimolai
27. Chemokine Receptors and AIDS, edited by Thomas R. O’Brien
28. Antimicrobial Pharmacodynamics in Theory and Clinical Practice,
edited by Charles H. Nightingale, Takeo Murakawa, and Paul G. Am-
brose
29. Pediatric Anaerobic Infections: Diagnosis and Management, Third
Edition, Revised and Expanded, Itzhak Brook

Additional Volumes in Production

Preface

To use antibiotics appropriately, the clinician needs to understand fundamental
pharmacodynamic concepts. These concepts are essential, for they form the very
basis for therapeutic strategies that maximize clinical benefit while minimizing
toxicity to the patient. The objectives of this book are, first, to review the constel-
lation of scientific and medical literature concerning antibiotics and pharmacody-
namics. The relevance of this complex information is then synthesized into an
easy-to-understand discussion of concept and theory. Finally, the reader is shown
how to apply these theories and concepts, with specific examples, to the clinical
practice of medicine and pharmacy. In other words, this book takes the reader
from the test tube, through the animal and human volunteer laboratory, to the
patient’s bedside.
The book includes a thorough discussion of the pharmacodynamics of all
major classes of the antimicrobial armamentarium. These include penicillins,
cephalosporins, cephamycins, carbapenems, monobactams, aminoglycosides,
quinolones, macrolides, antifungals, antivirals and others. Additionally, a phar-
macodynamic discussion of new classes of antimicrobial agents that are upon
the horizon, such as the ketolide antibiotics, is included.
This book is unique in that no other text of its kind currently exists. The
information that this book provides integrates medical microbiology, clinical in-
fectious diseases, and pharmacokinetics. This book pulls together in one text the
essential elements of these disciplines and does so in a very understandable and
practical manner.
The infectious disease physicians and pharmacists we selected as contribu-
tors are eminently qualified and are recognized experts in their field. Moreover,
these authors were chosen on the basis of their ability to convey their perspective

iii

iv
Preface

and expertise lucidly, which makes them ideal teachers. They all agreed that there
was a need for such a book and were excited about joining in this venture.
This book will find an audience in a large array of healthcare disciplines,
including college educators, medical, pharmacy, and microbiology students, in-
fectious disease physicians and pharmacy specialists, medical house staff, clinical
and staff pharmacists, clinical microbiologists, and other healthcare decision
makers.

Charles H. Nightingale
Takeo Murakawa
Paul G. Ambrose

Contents

Preface
iii
Contributors
vii

1.
Pharmacodynamics of Antimicrobials: General Concepts and
Applications
1
William A. Craig

2.
Microbiology and Pharmacokinetics
23
Charles H. Nightingale and Takeo Murakawa

3.
In Vitro Antibiotic Pharmacodynamic Models
41
Michael J. Rybak, George P. Allen, and Ellie Hershberger

4.
Animal Models of Infection for the Study of Antibiotic
Pharmacodynamics
67
Michael N. Dudley and David Griffith

5.
β-Lactam Pharmacodynamics
99
JoCarol J. McNabb and Khanh Q. Bui

6.
Aminoglycoside Pharmacodynamics
125
Myo-Kyoung Kim and David P. Nicolau

7.
Pharmacodynamics of Quinolones
155
Robert C. Owens, Jr. and Paul G. Ambrose

v

vi
Preface

8.
Glycopeptide Pharmacodynamics
177
Gigi H. Ross, David H. Wright, John C. Rotschafer, and
Khalid H. Ibrahim

9.
Macrolide, Azalide, and Ketolide Pharmacodynamics
205
Charles H. Nightingale and Holly M. Mattoes

10.
Metronidazole, Clindamycin, and Streptogramin
Pharmacodynamics
221
Kenneth Lamp, Melinda K. Lacy, and Collin Freeman

11.
Tetracycline Pharmacodynamics
247
Burke A. Cunha and Holly M. Mattoes

12.
Pharmacodynamics of Antivirals
259
George L. Drusano, Sandra L. Preston, and Peter J. Piliero

13.
Antifungal Pharmacodynamics
285
Michael E. Klepser and Russell E. Lewis

14.
Human Pharmacodynamics of Anti-Infectives: Determination
from Clinical Trial Data
303
George L. Drusano

15.
Antibacterial Resistance
327
Philip D. Lister

16.
Basic Pharmacoeconomics
367
Mark A. Richerson and Eugene Moore

17.
Utilizing Pharmacodynamics and Pharmacoeconomics in
Clinical and Formulary Decision Making
385
Paul G. Ambrose, Annette Zoe-Powers, Rene´ Russo,
David T. Jones, and Robert C. Owens, Jr.

Index
409

Contributors

George P. Allen, Pharm.D.
Postdoctoral Fellow, Pharmacy Practice, Wayne
State University, and Detroit Receiving Hospital and University Health Center
Detroit, Michigan

Paul G. Ambrose, Pharm.D.
Director, Infectious Disease Research, Cognigen
Corporation, Buffalo, New York

Khanh Q. Bui, Pharm.D.
Bristol-Myers Squibb Company, Chicago, Illinois

William A. Craig, M.D.
Professor of Medicine and Therapeutics, Department
of Infectious Diseases, University of Wisconsin, and William S. Middleton Me-
morial Veterans Hospital, Madison, Wisconsin

Burke A. Cunha, M.D.
Chief, Infectious Disease Division, Winthrop-
University Hospital, Mineola, and Professor of Medicine, State University of
New York School of Medicine, Stony Brook, New York

George L. Drusano, M.D.
Professor, Department of Medicine and Pharmacol-
ogy, Clinical Research Institute, Albany Medical College, Albany, New York

vii