1. Pharmacodynamics of Antimicrobials William A. Craig, M.D. University of Wisconsin-Madison

2. Potency: 1. MIC 2. MBC Time Course of Activity: 1. Rate of killing and effect of increasing concentrations 2. Persistent effects (PAE, PA-SME, and PALE) Parameters of Antimicrobial Activity

3. Patterns of Antimicrobial Activity  Concentration-dependent killing and prolonged persistent effects  Seen with aminoglycosides, fluoroquinolones, daptomycin and amphotericin B  Goal of dosing regimen: maximize concentrations; once-daily dosing  AUC/MIC and Peak/MIC major parameters correlating with efficacy

4. Patterns of Antimicrobial Activity  Time-dependent killing and minimal to moderate persistent effects  Seen with penicillins, cephalosporins, aztreonam, carbapenems, tribactams, clindamycin, macrolides, and oxazolidinones  Goal of dosing regimen: optimize duration of exposure; continuous infusion  Time above MIC (T>MIC) is major parameter correlating with efficacy

5. Patterns of Antimicrobial Activity  Time-dependent killing and prolonged persistent effects (duration related to AUC)  Seen with glycopeptides, tetracyclines, azithromycin, ketolides, streptogramins, glycylcyclines, everninomicins, and fluconazole  Goal of dosing regimen: optimize amount of drug  AUC/MIC major parameter correlating with efficacy