Antimicrobial Pharmacodynamics in Bacterial Infections
Summary
Antimicrobial pharmacodynamics explores how antibiotic concentrations interact with bacterial pathogens to inhibit growth or achieve kill. Central to this field are pharmacokinetic/pharmacodynamic (PK/PD) indices such as the time that drug concentrations remain above the minimum inhibitory concentration (T>MIC), the peak concentration to MIC ratio (Cmax/MIC) and the area under the concentration–time curve to MIC ratio (AUC/MIC). Time‐dependent agents, notably β‐lactams, require prolonged exposure above the MIC to maximise efficacy, whereas concentration‐dependent agents such as aminoglycosides rely on high peak levels relative to MIC. Tetracycline‐class compounds often achieve optimal outcomes when the AUC/MIC threshold is met, reflecting both sustained exposure and moderate post‐antibiotic effect. Advanced PD modelling—including hollow‐fibre systems and Monte Carlo simulations—enables prediction of target attainment probabilities, supports dose selection in special populations and informs strategies to minimise the emergence of resistance. Across a spectrum of pathogens and infection sites, integration of PK profiles, MIC distributions and resistance mechanisms underpins rational regimen design, with global implications for combating multidrug‐resistant organisms and preserving antibiotic utility.
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Antimicrobial Pharmacodynamics in Bacterial Infections publication trend
The graph below shows the total number of articles in antimicrobial pharmacodynamics in bacterial infections across all publications each year (not limited to Nature Index journals).
Technical terms
Minimum inhibitory concentration (MIC): The lowest antimicrobial concentration that visibly inhibits bacterial growth.
AUC/MIC ratio: The quotient of the drug’s area under the concentration–time curve by the MIC; a key determinant of efficacy for concentration-dependent agents.
Time above MIC (T>MIC): The cumulative period during which antibiotic levels exceed the MIC; critical for time-dependent killing.
Concentration‐dependent killing: A PD pattern in which the magnitude of the peak concentration relative to MIC governs bacterial kill rate.
Post-antibiotic effect (PAE): The interval of suppressed bacterial regrowth following brief exposure to an antibiotic.
References
- In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Urinary Isolates. Antibiotics (2023).
- Comparison of Omadacycline and Tigecycline Pharmacokinetics in the Plasma, Epithelial Lining Fluid, and Alveolar Cells of Healthy Adult Subjects. Antimicrobial Agents and Chemotherapy (2017).
- The Development of Third-Generation Tetracycline Antibiotics and New Perspectives. Pharmaceutics (2021).
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