Vol.60 No.1 January 2012
Breakpoints based on pharmacokinetics-pharmacodynamics theory in urinary tract infections
Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Kita-ku, Okayama, Japan
Abstract
Clinical and Laboratory Standards Institute(CLSI) breakpoints are the most commonly used MIC breakpoints for antimicrobial agents in urinary tract infections. However, CLSI breakpoints do not reflect antimicrobial pharmacokinetic characteristics of the urinary tract. Thus, the use of these breakpoints becomes problematic. The Japanese Society of Chemotherapy has published "Breakpoints of Antimicrobial Agents in Urinary Tract Infections." These breakpoints take into account the characteristics of the urinary tract, but they lack flexibility such as when the administration method is changed. In recent years, it is becoming more prevalent to use breakpoints based on pharmacokinetics(PK)-pharmacodynamics(PD) theory to provide a more scientific method of antimicrobial administration. These PK-PD breakpoints enable flexible and scientific administration which takes into account changes in dose and administration of antimicrobial agents. There have not been many findings regarding PK-PD in urinary tract infections. However, the use of PK-PD breakpoints should become mainstream practice in urinary tract infections.
Key word
urinary tract infection, breakpoint, PK-PD
Received
November 14, 2011
Accepted
November 28, 2011
Jpn. J. Chemother. 60 (1): 7-11, 2012
