Pharmacodynamic interactions of antibiotics alone and in combination

Jerome J. Schentag, Laura C. Strenkoski-Nix, David E. Nix, Alan Forrest

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Clinical trials show that the area under the inhibitory curve (AUIC) is predictive of antibacterial killing rates in patients with nosocomial pneumonia and is useful for predicting clinical or microbiological outcomes and making dosage adjustments with β-lactams, quinolones, aminoglycosides, and vancomycin. The AUIC values of two antibiotics are additive, and since antibiotics are often given in combination, determining the AUIC for antibiotic combinations could potentially predict the microbiological outcomes for patients given these combinations. To further address this question, mathematical modeling was used to study in vitro pharmacokinetic and pharmacodynamic interactions of the antimicrobials piperacillin and ciprofloxacin. These agents were also studied in vivo in healthy volunteers. Blood samples were obtained for analysis of serum drug concentrations, and serum inhibitory titers were determined against eight common bacterial pathogens, chosen to reflect the range of MIC values to ciprofloxacin and piperacillin. Additive AUIC relationships predictive of bacterial killing rates were typical in patients given these antibiotics in combination.

Original languageEnglish (US)
Pages (from-to)40-46
Number of pages7
JournalClinical Infectious Diseases
Volume27
Issue number1
StatePublished - 1998
Externally publishedYes

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Area Under Curve
Anti-Bacterial Agents
Piperacillin
Ciprofloxacin
Lactams
Quinolones
Aminoglycosides
Vancomycin
Serum
Pneumonia
Healthy Volunteers
Pharmacokinetics
Clinical Trials
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Immunology

Cite this

Schentag, J. J., Strenkoski-Nix, L. C., Nix, D. E., & Forrest, A. (1998). Pharmacodynamic interactions of antibiotics alone and in combination. Clinical Infectious Diseases, 27(1), 40-46.

Pharmacodynamic interactions of antibiotics alone and in combination. / Schentag, Jerome J.; Strenkoski-Nix, Laura C.; Nix, David E.; Forrest, Alan.

In: Clinical Infectious Diseases, Vol. 27, No. 1, 1998, p. 40-46.

Research output: Contribution to journalArticle

Schentag, JJ, Strenkoski-Nix, LC, Nix, DE & Forrest, A 1998, 'Pharmacodynamic interactions of antibiotics alone and in combination', Clinical Infectious Diseases, vol. 27, no. 1, pp. 40-46.
Schentag, Jerome J. ; Strenkoski-Nix, Laura C. ; Nix, David E. ; Forrest, Alan. / Pharmacodynamic interactions of antibiotics alone and in combination. In: Clinical Infectious Diseases. 1998 ; Vol. 27, No. 1. pp. 40-46.
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