The Clinical Relevance of Protein Binding and Tissue Concentrations in Antimicrobial Therapy

摘要: The relevance of protein binding, molecular size and lipophilicity to tissue penetration antimicrobials is discussed, the clinical these agents assessed. In order assess any factor on outcome a group infections it necessary obtain some form dose response; i.e. has be (intentionally or otherwise) titrated down until negative responses are seen. Information failures tends not reported, hence useful data difficult obtain. binding microbiological activity drug important use highly bound in readily assessable diseases illustrated with few examples: poor efficacy fusidic acid gonorrhoea, when high failure rates found doses 2g; ceftriaxone at (25mg) which one would expect cures, associated significant failures; cefoperazone serious illness can related degree binding. (protein apart) urinary tract (where ample evidence available), chest somewhat fewer but probably convincing) meningitis where experimental firm information less available.