| Optimizing use of quinolones in the critically ill. | |
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MedLine Citation:
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PMID: 18095222 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fluoroquinolones (FQs) are broad spectrum, concentration dependent, bactericidal antimicrobials that have been commonly utilized to treat severe nosocomial infections. FQ activity is derived from their ability to inhibit DNA gyrase and topoisomerase IV; resistance has been shown to develop in target site mutations, alterations in efflux pump systems, and incorporation of plasmids. The probability of preventing emergence of resistance and achieving maximal rates of kill are best related to the ratio of free-drug in the area under the concentration-time curve (AUC) to minimum inhibitory concentration (AUC:MIC). Major dosage adjustments for FQs are not necessary in hepatic insufficiency, accumulation of extracellular fluids, and burn patients. Appropriate dosage adjustments in renal function should be taken into consideration. FQ optimization in the critically ill is a multifactorial process that should be individualized to each patient and should take into account the MIC of the pathogen, pharmacokinetic/pharmacodynamic profile of the FQ, and the patient's pathophysiological state. |
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Authors:
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Jenny C Yang; Brian T Tsuji; Alan Forrest |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Seminars in respiratory and critical care medicine Volume: 28 ISSN: 1069-3424 ISO Abbreviation: Semin Respir Crit Care Med Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-20 Completed Date: 2008-03-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9431858 Medline TA: Semin Respir Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 586-95 Citation Subset: IM |
Affiliation:
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SUNY-Buffalo School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14206, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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pharmacology* Critical Illness* / therapy Cross Infection / drug therapy* Drug Resistance, Bacterial Fluoroquinolones / pharmacology* Humans Microbial Sensitivity Tests |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Fluoroquinolones |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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