Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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This review summarizes key data illustrating the clinical importance of pharmacodynamics, particularly among the fluoroquinolone family of antibacterials. Antibacterials are often divided into 2 groups--either time-dependent or concentration-dependent agents--on the basis of their mechanism of killing. Fluoroquinolones are concentration-dependent agents, and the parameter that correlates most closely with clinical and/or bacteriological success is the ratio of the area under plasma concentration curve (AUC) to the minimum inhibitory concentration (MIC). ⋯ For example, a ratio of at least 30 is often cited as optimal to achieve success against Streptococcus pneumoniae, whereas higher ratios (>100) are considered to be optimal for the treatment of infections due to gram-negative bacilli. Data are cited to suggest that the minimum ratio necessary to prevent the selection of resistant mutants may, in fact, be somewhat higher. Maximizing the AUC : MIC through the use of potent therapy may offer an opportunity to limit the development of resistance to fluoroquinolones.