Building in efficacy: developing solutions to combat drug‐resistant S

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Presentation transcript:

Building in efficacy: developing solutions to combat drug‐resistant S Building in efficacy: developing solutions to combat drug‐resistant S. pneumoniae M.R. Jacobs Clinical Microbiology and Infection Volume 10, Pages 18-27 (January 2004) DOI: 10.1111/j.1470-9465.2004.00862.x Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 1 Mortality in hospitalised patients with lobar pneumonia: sulfonamide vs. no treatment. Adapted from reference 1. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 2 Correlation between MIC for (a) clarithromycin and (b) azithromycin against S. pneumoniae and end‐of‐treatment survival in a mouse model simulating human PK. Adapted from reference 22. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 3 Use of PK/PD breakpoints to predict efficacy of azithromycin against azithromycin‐susceptible S. pneumoniae, azithromycin‐resistant S. pneumoniae with either mef(A) or erm(B), and H. influenzae. Adapted from reference 26. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 4 Relationship between MIC and T > MIC for maximal bacterial eradication: amoxicillin and cefpodoxime against S. pneumoniae in a mouse thigh model. Adapted from references 41 and 42. Broken arrows indicate T > MIC required to maintain efficacy. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 5 Use of PK/PD breakpoints to predict efficacy of cefaclor against penicillin‐susceptible S. pneumoniae, penicillin‐intermediate S. pneumoniae, penicillin‐resistant S. pneumoniae, H. influenzae and M. catarrhalis. Adapted from references 43 and 44. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 6 Use of PK/PD breakpoints to predict efficacy of amoxicillin/clavulanate 875/125 mg against penicillin‐susceptible S. pneumoniae, penicillin‐intermediate S. pneumoniae, penicillin‐resistant S. pneumoniae, H. influenzae and M. catarrhalis. Adapted from reference 44. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 7 Use of PK/PD breakpoints to predict efficacy of amoxicillin/clavulanate 2000/125 mg against penicillin‐susceptible S. pneumoniae, penicillin‐intermediate S. pneumoniae, penicillin‐resistant S. pneumoniae, H. influenzae and M. catarrhalis. Adapted from references 44 and 45. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 8 Target T > MIC and T > MIC achieved with various amoxicillin/clavulanate formulations. Adapted from references 13 and 45. Clinical Microbiology and Infection 2004 10, 18-27DOI: (10.1111/j.1470-9465.2004.00862.x) Copyright © 2004 European Society of Clinical Infectious Diseases Terms and Conditions