Chapter

Comparative and Veterinary Pharmacology

Volume 199 of the series Handbook of Experimental Pharmacology pp 227-264

Date:

Antimicrobial Drug Resistance

  • Marilyn MartinezAffiliated withOffice of New Animal Drug Evaluation (HFV-130), Center for Veterinary Medicine Food and Drug Administration Email author 
  • , Peter SilleyAffiliated withMB Consult Limited, Enterprise House

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Abstract

This chapter provides an overview of our current understanding of the mechanisms associated with the development of antimicrobial drug resistance, international differences in definitions of resistance, ongoing efforts to track shifts in drug susceptibility, and factors that can influence the selection of therapeutic intervention. The latter presents a matrix of complex variables that includes the mechanism of drug action, the pharmacokinetics (PK) of the antimicrobial agent in the targeted patient population, the pharmacodynamics (PD) of the bacterial response to the antimicrobial agent, the PK/PD relationship that will influence dose selection, and the integrity of the host immune system. Finally, the differences between bacterial tolerance and bacterial resistance are considered, and the potential for non-traditional anti-infective therapies is discussed.

Keywords

Antimicrobial resistance PK/PD Dose selection Antimicrobial tolerance