Pharmacodynamic considerations for the selection of oral cephalosporins in the treatment of rhinosinusitis.

Abstract

The elimination of an infection occurs when the antibiotic reaches the site of the pathogen in adequate concentrations for an appropriate length of time. To predict whether an antibiotic will achieve this goal, one must have a familiarity with pharmacodynamic concepts that integrate the drug's microbiological activity, its pharmacokinetic properties, and its mode of bacterial killing. For the cephalosporins, it is the time or duration that the concentrations in serum or interstitial fluid remain above their mean inhibitory concentration for the pathogen that best correlates with clinical outcomes. The application of this pharmacodynamic profile can assist in the decision process to distinguish one oral cephalosporin from another and, therefore, provides an opportunity for maximizing the probability of good clinical outcomes while minimizing the potential for the selection of resistance.