PK / PD (pharmacokinetics / pharmacodynamics) 
like magic

09-12-00

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Table of Contents

PK / PD (pharmacokinetics / pharmacodynamics) like magic

The ideal antibiotic ...

Will it always be ideal ?

Main causes of antibiotic failures... Adapted from Pechère J.C., 1988, 1993, 1998

Pharmacokinetics / pharmacodynamics as a step towards therapy...

Pharmacokinetics ...

Pharmacodynamics ...

Pharmacokinetics / Pharmacodynamics in drug development and evaluation of efficacy 

PK/PD in drug develop-ment A view from FDA

Are PK/PD important for efficacy / toxicity ?

Pharmacokinetic/ Pharmacodynamics and antibiotic resistance...

Are PK / PD important in resistance ?

PK/PD parameters: a first sight

PK/PD parameters : a 2d sight

Pharmacokinetics / Pharmacodynamics

PK/PD patterns of antimicrobial activity (1 of 3) (after WA. Craig, 2000)

PK/PD patterns of antimicrobial activity (2 of 3) (after WA. Craig, 2000)

PK/PD patterns of antimicrobial activity (3 of 3) (after WA. Craig, 2000)

PK/PD: role of concentration an example with extracellular Listeria monocytogenes

Role of extracellular concentration an example with intracellluar Listeria monocytogenes

Pharmacokinetics / Pharmacodynamics in action ... 

Aminoglycosides : obtain a peak !

Aminoglycosides: practical applications for a 30 min infusion

Pharmacokinetics / Pharmacodynamics in action ... 

Pharmacokinetics / Pharmacodynamics in action ... 

?-lactams : remain at least 50 % of the time above the MIC...

Typical pharmacokinetics of a model ?-lactam *

? - lactams * in clinical practice: 

Pharmacokinetics / Pharmacodynamics in action ... 

? - lactams * in clinical practice: giving them more frequently 

? - lactams * in clinical practice : influence of the schedule on potential breakpoint

Pharmacokinetics / Pharmacodynamics in action ... 

PK/PD of fluoroquinolones: role of the 24h-AUC MIC ciprofloxacin in hospital-acquired pneumonia

AUC / MIC ratio

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Pharmacokinetics / Pharmacodynamics in action ... 

24h-AUC / MIC as a tool to determine acceptable sensitivities to fluoroquinolones (p.o.)

The role of the peak for fluoroquinolones ...

Peak concentrations as a tool to determine acceptable sensitivities to fluoroquinolones (p.o.)

Combining it all Ö(Peak and 24h-AUC / MIC) as predictors of efficacy of FQ ...

Pharmacokinetics / Pharmacodynamics in action ...

Pharmacokinetics / Pharmacodynamics in action ... 

Where are we ?

Can we simplify it all ?... 

Can we simplify it all ?... 

AUC24h / MIC and ?-lactams... 

Adapting ?-lactam dosages based on AUC24h / MIC

Adapting ciprofloxacin dosage based on AUC24h / MIC

AUC24h / MIC and aminoglycosides ... 

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PK / PD: do they help ?

and let us hope we have a bright future...

Isnít that all magic ? ...

Author: Paul M. Tulkens 

Email: tulkens@facm.ucl.ac.be

Home Page: http://www.md.ucl.ac.be/facm/facm-conferences.htm