抗生素的药效动力学Pharmacodynamics of Antibioticsppt课件.pptVIP

Pharmacodynamics of Antibiotics;Concepts;Minimum Inhibitory Concentration (MIC) The lowest concentration of an antibiotic that inhibits bacterial growth after 16-20 hrs incubation. Minimum Bacteriocidal Concentrations. The lowest concentration of an antibiotic required to kill 99.9% bacterial growth after 16-20 hrs exposure. C-p Peak antibiotic concentration Area under the curve (AUC) Amount of antibiotic delivered over a specific time.;Antimicrobial-micro-organism interaction;Static versus Cidal;Questions;Can this antibiotic inhibit/kill these bacteria?;;What concentration of this antibiotic is needed to inhibit/kill bacteria?;Patterns of Microbial Killing;Persistent Effects;Post-antibiotic sub-MIC effect. Prolonged drug level at sub-MIC augment the post-antibiotic effect. Post-antibiotic leukocyte killing enhancement. Augmentation of intracellular killing by leukocytes. The longest PAE with antibiotics exhibiting this characteristic.;Patterns of Antimicrobial Activity;Time-dependent killing and minimal to moderate persistent effects Goal of dosing Maximize duration of exposure PK parameter determining efficacy Time above the MIC Examples Beta lactam, macrolides, clindamycin, flucytosine, linezolid.;Patterns of Antimicrobial Activity;PK/PD patterns;Hours;Log 10 CFU/thigh;Log 10 CFU/thigh;Log 10 CFU/thigh;Mortality%;Mortality%;Percentage bacteriologic cure for ?-lactam agents against Streptococcus pneumoniae (black circle) and Haemophilus influenzae (white circle) in children with acute otitis media ;MIC;Aminoglycosides;MIC;MIC;Effects of PD on breakpoints Recommended for many antibiotics for S. pneumoniae