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pharmacokinetics, pharmacodynamics, concentration-dependent antibacterial activity, time-dependent antibacterial activity

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Khaitovych, M. (2017). PHARMACOKINETIC/PHARMACODYNAMIC MODEL OF ANTIBIOTIC THERAPY: CLINICAL USAGE. Medical Science of Ukraine (MSU), 12(3-4), 114-121. Retrieved from


Resume. Nowadays administration of antibacterial drugs requires appropriate knowledge of clinical pharmacology and clinical microbiology.

The «gold standard» in study of antibiotics’ activity is determination of minimal inhibitory concentration (MIC).

It was emphasized 3 groups of antibacterial drugs according to pharmacokinetic / pharmacodynamic (PC/PD) model, which effectiveness depend on concentration of antibiotic in blood; time of exposition; total exposition, which reflects area under the curve.

To the first group belong drugs, which have concentration-dependent bactericidal action (Cmax>МIC) and characterizes long-term postantibiotic effect (PAE) (aminoglycosides, metronidazole, ketolides etc.). For instance, in case of administration of gentamycin ratio Cmax/МIC 8:1 against gram-negative microorganism 1 time per day allow to obtain positive result and avoid adverse reactions.

To the second group relate beta-lactam antibiotics, for which are indicative time-dependent (T>MIC) bactericidal action in case of minimal PAE (except carbapenems). More frequent administration prolongs time (optimally -40-50% of dosage interval duration), when concentration become higher than MIC. Furthermore, prolonged infusions are used (up to 3 hours).

To the third group of antibiotics of PC/PD model respectively refer bacteriostatic drugs (azithromycin, clindamycin, tetracycline, tigecycline, linezolide etc.) as well as vancomycin and fluoroquinolones. For obtainment of clinical results in most of antibiotics of this group the ratio 24AUC/MIC must be 25-30 for gram-positive and 100-125 for gram-negative microorganisms.

Conclusion. So, the usage of PC/PD model offer the ability to manage of antibiotic transformation in the patient organism for the development of maximum possible effective and safety treatment, preventing antibiotic resistance.

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