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Pharmacokinetics and pharmacodynamics (PK/PD) of fluoroquinolones: tools for combating bacteria and preventing resistance

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Fluoroquinolone Antibiotics

Part of the book series: Milestones in Drug Therapy ((MDT))

Abstract

High rates of penicillin-resistant and multi-drug resistant organisms are influencing the empiric treatment of respiratory infections and allowing the new fluoroquinolones (FQs) (e.g., gatifloxacin, gemifloxacin, levofloxacin and moxifloxacin) to serve as important treatment alternatives. Selection of the optimal fluoroquinolone dosing regimen, however, requires careful consideration of not only organism and patient-specific factors but also pharmacokinetics (PK) and pharmacodynamic (PD) characteristics. The newer FQs display excellent bioavailability and have longer serum half lives than ciprofloxacin. In addition, they have the ability to concentrate in respiratory tract tissues and fluids at levels that exceed serum-drug concentrations. The broad spectrum of activity including against antibiotic resistant organisms as well as favorable pharmacokinetics makes the new FQs attractive therapeutic alternatives to traditional agents for common respiratory infections. Understanding the PKIPD of fluoroquinolone (FQ) antibiotics can facilitate selection of optimal regimens to hasten response, prevent treatment failures, and minimize the development of resistance. Although this paper will discuss all recently developed fluoroquinolones, the focus will be on recent data with agents currently used or soon to be available for clinical use (e.g., ciprofloxacin, gatifloxacin, gemifloxacin, levofloxacin and moxifloxacin). This review describes the PK and PD characteristics of the new FQs and discusses its implication on adequate therapy of patients with respiratory infections.

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Authors and Affiliations

  1. Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Canada

    George G. Zhanel

  2. Departments of Clinical Microbiology and Medicine, Health Sciences Centre, Winnipeg, Manitoba, Canada

    Ayman M. Noreddin

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  1. George G. Zhanel
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  1. Faculty of Medicine, The University of Manitoba, 409 Tacho Avenue, Winnipeg, Manitoba, R2H 2A6, Canada

    Allan R. Ronald

  2. Microbiology Laboratory, Mt. Sinai Hospital, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada

    Donald E. Low

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Zhanel, G.G., Noreddin, A.M. (2003). Pharmacokinetics and pharmacodynamics (PK/PD) of fluoroquinolones: tools for combating bacteria and preventing resistance. In: Ronald, A.R., Low, D.E. (eds) Fluoroquinolone Antibiotics. Milestones in Drug Therapy. Birkhäuser, Basel. https://doi.org/10.1007/978-3-0348-8103-6_5

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  • DOI: https://doi.org/10.1007/978-3-0348-8103-6_5

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