Parenteral Antibiotic Therapy in the Treatment of Lower Respiratory Tract Infections. Strategies to Minimize the Development of Antibiotic Resistance

Cazzola, Mario; Matera, Maria Gabriella; Noschese, Paolo

doi:10.1006/pupt.2000.0253

Cited by 12 publications

(4 citation statements)

References 33 publications

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“…The characterization of the kinetic profile of drugs in specific organs or tissues is becoming increasingly interesting since pharmacological and toxicological responses are more closely related to drug concentrations at target sites than in plasma. This is even more important in the case of antimicrobial agents because inadequate levels at the site of infection lead not only to clinical failure but also to the development of drug resistance (Cazzola et al 2000;Andes 2001). Despite the general consensus concerning the relevance of this issue, most pharmacokinetic studies only provide information about the kinetic profile of drugs in plasma, whereas distribution data are generally reduced to a few drug concentrations in the main body tissues.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of the disposition of levofloxacin, netilmicin and cefepime in the isolated rat lung

Martínez

Gandarillas

Lanao

et al. 2005

Journal of Pharmacy and Pharmacology

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An experimental model of artificially perfused and mechanically ventilated lung has been applied to compare the kinetic behaviour of levofloxacin, cefepime and netilmicin in this body tissue. The study has been performed to explore the usefulness of the isolated lung technique in the pharmacokinetic field, particularly to study the disposition of antibiotics in pulmonary tissue. The lung was perfused with Krebs-Henseleit medium containing 3% bovine albumin at a flow rate of 5 mL min(-1). It was ventilated at 60 respirations/min with a 2-mL tidal volume of air previously humidified and warmed to 37 degrees C. The concentrations of the above antibiotics were determined by HPLC techniques and the outflow curves were analysed by stochastic, as well as by model-dependent, methods. The results show pharmacokinetic differences among these antibiotics, which are in accordance with previously reported data, levofloxacin being the drug with the highest distribution coefficient in this tissue (1.25 +/- 0.14 vs 0.39 +/- 0.07 and 0.41 +/- 0.06 mL g(-1) for netilmicin and cefepime, respectively). Accordingly, the isolated lung of the rat, under the experimental conditions used here, constitutes an alternative model to be incorporated to pharmacokinetic studies with a great potential use for those drugs that show a pharmacological or toxicological action depending on the kinetic profile in the lung tissue.

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Section: Discussionmentioning

confidence: 99%

Comparative study of the disposition of levofloxacin, netilmicin and cefepime in the isolated rat lung

Martínez

Gandarillas

Lanao

et al. 2005

Journal of Pharmacy and Pharmacology

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“…An antibiotic with strong bactericidal efficacy and tissue and/or serum concentrations more extensive than the MIC or, better, minimal bactericidal concentration throughout the dosage period is equally beneficial in preventing antibiotic resistance development. 33…”

Section: Need For Gentamicin As Non-invasive Formulationmentioning

confidence: 99%

Advances in in vivo Non-invasive Delivery of Gentamicin

Bhattacharjee¹,

Chakraborty²,

Chaulya³

et al. 2023

Ind. J. Pharm. Edu. Res.

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Introduction: Parenteral administration of gentamicin is a globally known therapeutic strategy for severe infections, including severe community acquired pneumonia, complex severe acute malnourishment, neonatal and pediatric sepsis. The drug is also prescribed as an ophthalmologic anti-infective. In most cases, the therapeutic course necessitates frequent bolus medication doses, lengthy hospitalization, and ongoing therapeutic monitoring; hence a qualified healthcare provider is required. Objectives: Gentamicin is a hydrophilic drug and has a short half-life, making it difficult to achieve appropriate systemic concentrations when taken parenterally. The use of innovative oral medication delivery systems is justified in this context. Furthermore, new delivery strategies can increase the membrane permeability of gentamicin. Conclusion: The current analysis provides a detailed summary of gentamicin's research history as well as several developing drug delivery strategies that have been explored. The examples included in the paper give important evidence on innovative delivery systems for gentamicin in the domain of antimicrobial investigations opening a way for upcoming therapeutics that may provide better clinical outcomes.

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“…Pur riconoscendo una correlazione diretta tra quantità di antibiotici prescritti sul territorio e prevalenza di resistenze agli stessi, l'elevato uso di cefalosporine e beta-lattamine iniettive comporterebbe una riduzione del rischio di indurre selezione di ceppi patogeni perché la somministrazione parenterale induce concentrazioni plasmatiche e tissutali più elevate capaci di eradicare rapidamente i patogeni sensibili, limitando la pressione selettiva [31].…”

Section: Figuraunclassified

L’uso appropriato di antibiotici iniettivi a domicilio: criteri epidemiologici, clinici e farmacoeconomici

Eandi

Serra

2005

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M. Eandi, R. Serra INTRODUZIONEL'utilizzo da parte del medico di Medicina Generale degli antibiotici iniettabili in ambito extra-ospedaliero viene fortemente disincentivato, in Italia, da due differenti note AIFA (ex note CUF), che vincolano la prescrizione a carico del SSN rispettivamente a specifiche condizioni cliniche (nota 55) o alla necessità di garantire la continuità terapeutica ospedale-domicilio (nota 56), nel caso di terapie iniziate in ospedale (tabella I).Le giustificazioni addotte per introdurre queste note e le relative limitazioni sono di varia natura e comprendono la necessità di razionalizzare l'uso degli antibiotici sul territorio e di contenere la spesa farmaceutica pubblica, la preoccupazione di limitare il rischio d'insorgenza e diffusione di nuove resistenze agli antibiotici, l'opportunità di riservare ai medici ospedalieri l'utilizzo di alcuni potenti e poco maneggevoli antibiotici parenterali per L'uso appropriato di antibiotici iniettivi a domicilio: criteri epidemiologici, clinici e farmacoeconomici Mario Eandi*, Roberto Serra°A BSTRACT Outpatient parenteral antibiotic therapy (OPAT) has become an increasingly used therapeutic modality during the last 20 years. Reasons for this rapid growth include OPAT's many patient benefits as well as the development of new technologies and well-documented cost savings. Recently the Italian Drug Agency (AIFA) has revised the list of drug's limitations and indications; particularly two notes about OPAT (n. 55-n.56) have been modified. These new notes can assume at least a double significance: if on the one hand they try to put a check on the overuse and misuse of OPAT, steering physicians towards a better utilization of parenteral antibiotics, on the other they allow to prescribe OPAT also in case of non-ordinary infections, promoting development of more structured OPAT programmes. Prescribing physicians should be aware of a number of aspects of OPAT which distinguish it from other forms of therapy: multiple factors must be taken into account, including the probable infecting organism, the pharmacodynamic and pharmacokinetic properties of candidate drugs, the capabilities of patients who will receive OPAT and of their caregivers. The Infectious Diseases Society of America (IDSA) Guidelines have been elaborated to help physicians thorough assessment of OPAT suitability, even if they need to be adapted to many variables in each treatment setting. Aim of the present study is to re-consider the main microbiologic, clinical and pharmacoeconomic criteria supporting the prescription of an outpatient parenteral antibiotic therapy after the publication of the new AIFA notes. salvaguardare il più a lungo possibile la loro elevata efficacia terapeutica e per ridurre il rischio di effetti tossici correlabili alla loro criticità d'uso [1]. KeywordsSecondo stime dell'Osservatorio Nazionale sull'Impiego dei Medicinali (OsMED), la prescrizione degli antibiotici iniettabili soggetti a nota CUF, globalmente considerati, ha continuato a manifestare un sensibile trend n...

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Parenteral Antibiotic Therapy in the Treatment of Lower Respiratory Tract Infections. Strategies to Minimize the Development of Antibiotic Resistance

Cited by 12 publications

References 33 publications

Comparative study of the disposition of levofloxacin, netilmicin and cefepime in the isolated rat lung

Comparative study of the disposition of levofloxacin, netilmicin and cefepime in the isolated rat lung

Advances in in vivo Non-invasive Delivery of Gentamicin

L’uso appropriato di antibiotici iniettivi a domicilio: criteri epidemiologici, clinici e farmacoeconomici

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