J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 518KB） [Members Only]

J.Jpn. Surg. Soc.. 107(5): 224-229, 2006

Feature topic

THERAPEUTIC ANTIMICROBIAL AGENTS FOR POSTOPERATIVE INFECTIONS: APPROPRIATE USE OF ANTIBIOTICS FROM THE VIEWPOINT OF PHARMACOKINETIC/PHARMACODYNAMIC THEORY

1) Division of Infection Control and Prevention, Hyogo College of Medicine, Nishinomiya, Japan
2) 2nd Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan

Yoshio Takesue1), Kazuhiko Nakajima1), Yasunao Wada1), Kaori Ichiki1), Hidenori Yanagi2), Hiroki Ikeuchi2)

Pharmacokinetic/pharmacodynamic　（PK/PD）　parameters can be used predict the potential for bacterial eradication with antimicrobial therapy. The validity of these parameters is supported by both animal and clinical studies. Two major patterns of antimicrobial activities are time-dependent killing and concentration-dependent killing. Time-dependent killing is characteristic of beta-lactams. The major PK/PD parameter correlating with efficacy is a serum concentration of 50-60%　for cephalosporins and 30-40%　for carbapenems in the dosing interval, and these concentrations are the susceptibility limits for the dosing regimens used. It is recommended that these types of antibiotic be administered 3-4 times per day. Concentration-dependent killing is characteristic of aminoglycosides. The major PK/PD parameter correlating with the efficacy of these agents is the 24-h area under the curve or peak serum level. This type of antibiotic should be administered as the total daily dose once daily.

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