Table 4.
PK/PD characteristics of common antibiotics used in intensive care units
| Antibiotic | Gram+/− | Mechanism of action | PK/PD index | Vd (L/kg) | PB (%) | t½ (h) | Clearance | Solubility | References |
|---|---|---|---|---|---|---|---|---|---|
| β-lactam | |||||||||
| Meropenem | G+/G− | Bactericidal | T>MIC | 0.25 | 2 | 1 | Renal | Hydrophilic | [193, 194] |
| Cefuroxime | G+/G− | Bactericidal | T>MIC | 6.4–9.1 | 33–50 | 1.1 | Renal | Hydrophilic | [195] |
| Cefazolin | G+/G− | Bactericidal | T>MIC | 0.14 | 80–90 | 1.8 | Renal | Hydrophilic | [196, 197] |
| Piperacillin/tazobactam | G+/G− | Bactericidal | T>MIC | 0.38/0.31 | 25/30 | 1.14/0.92 | Renal | Hydrophilic | [198, 199] |
| Ampicillin/sulbactam | G+/G− | Bactericidal | T>MIC | 0.16/0.1 | 28/38 | 1/1 | Renal | Hydrophilic | [200–202] |
| Ceftolozane/tazobactam | G+/G− | Bactericidal | T>MIC | 0.19/0.31 | 21/30 | 2.77/0.92 | Renal | Hydrophilic | [203–205] |
| Glycopeptide | |||||||||
| Teicoplanin | G+ | Bacteriostatic |
AUC/MIC T>MIC |
0.7–1.4 | 90 | 70–100 | Renal | Hydrophilic | [206] |
| Vancomycin | G+ | Bactericidal |
AUC/MIC T>MIC |
0.4–1 | 10–50 | 6 | Renal | Hydrophilic | [207] |
| Lipopeptide | |||||||||
| Daptomycin | G+ | Bactericidal | AUC/MIC Cmax/MIC | 0.1 | 90 | 7.5–9 | Renal | Hydrophilic core lipophilic tail | [208–210] |
| Fosfomycin | G+/G− | Bactericidal | T>MIC | 1.4–2.4 | 10 | 2.9–8.5 | Renal | Hydrophilic | [211–213] |
| Glycylcycline | |||||||||
| Tigecycline | G+/G− | Bacteriostatic | AUC/MIC | 7–10 | 71–89 | 37–67 | Hepatic | Lipophilic | [214, 215] |
| Fluoroquinolone | |||||||||
| Ciprofloxacin | G+/G− | Bactericidal | AUC/MIC | 1.74–5 | 20–30 | 3–4 | Hepatic | Lipophilic | [216] |
| Moxifloxacin | G+/G− | Bactericidal | AUC/MIC | 1.65 | 30–50 | 12 | Hepatic | Lipophilic | [217] |
| Metronidazole | |||||||||
| Metronidazole | Anaerobic | Bactericidal | AUC/MIC | 0.51–1.1 | <20 | 6–10 | Renal | Hydrophilic | [218] |
| Aminoglycosides | |||||||||
| Gentamicin | G+/G− | Bactericidal |
Cmax/MIC AUC/MIC |
0.22–0.27 | 0–30 | 1.25 | Renal | Hydrophilic | [219] |
| Amikacin | G+/G− | Bactericidal |
Cmax/MIC AUC/MIC |
0.22–0.27 | <10 | 2–3 | Renal | Hydrophilic | [220] |
| Tobramycin | G+/G− | Bactericidal |
Cmax/MIC AUC/MIC |
0.25 | – | 2.2–2.4 | Renal | Hydrophilic | [221] |
| Macrolides | |||||||||
| Azithromycin | G+/G− | Bacteriostatic | AUC/MIC | 0.35–0.5 | <50 | 11–14 | Hepatic | Lipophilic | [222, 223] |
| Erythromycin | G+/G− | Bacteriostatic | AUC/MIC | 0.6–1.1 | 80–90 | 1.4–2.8 | Hepatic | Lipophilic | [224] |
| Polymyxins | |||||||||
| Colistin | G− | Bactericidal | AUC/MIC | 0.2 | >50 | 0.5 | Renal (prodrug) | Hydrophilic | [225] |
| Oxazolidinones | |||||||||
| Linezolid | G+ | Bactericidal, bacteriostatic |
AUC/MIC T>MIC |
0.7 | 31 | 4–6 | Hepatic, renal | Lipophilic | [226] |
AUC area under the plasma concentration–time curve, Cmax maximum plasma drug concentration, G+/G− Gram positive/negative, MIC minimum inhibitory concentration, PB protein binding, PK/PD pharmacokinetics/pharmacodynamics, T>MIC time above MIC, t½ elimination half-life, Vd volume of distribution