Pharmacokinetic and pharmacodynamic aspects of antimicrobial agents for the treatment of uncomplicated urinary tract infections

Int J Antimicrob Agents. 2006 Aug;28 Suppl 1:S35-41. doi: 10.1016/j.ijantimicag.2006.05.019. Epub 2006 Jul 7.

Abstract

Uncomplicated urinary tract infections (UTI) are treated with beta-lactams, co-trimoxazole, quinolones and fosfomycin tromethamine. Due to increasing resistance of causative pathogens, antibiotics should be used by considering their pharmacodynamic and pharmacokinetic characteristics. beta-lactams have time-dependent activity and should not be used once-daily. Co-trimoxazole should be restricted due to increasing chemoresistance. Fluoroquinolones play a primary role in the treatment of serious and complicated infections. Fosfomycin tromethamine is active against most urinary tract pathogens. In vitro time-kill kinetics of fosfomycin against Escherichia coli and Proteus mirabilis showed primarily concentration-dependent activity, with a prolonged post-antibiotic effect (3.4 to 4.7h). Based on these results a single 3g dose of fosfomycin guarantees optimal efficacy against common uropathogens with an AUC(urine)/MIC ratio of 500.

MeSH terms

  • Anti-Infective Agents / pharmacokinetics*
  • Anti-Infective Agents / pharmacology*
  • Fluoroquinolones / pharmacokinetics
  • Fluoroquinolones / pharmacology
  • Fosfomycin / pharmacokinetics
  • Fosfomycin / pharmacology
  • Humans
  • Nitrofurantoin / pharmacokinetics
  • Nitrofurantoin / pharmacology
  • Quinolones / pharmacokinetics
  • Quinolones / pharmacology
  • Trimethoprim, Sulfamethoxazole Drug Combination / pharmacokinetics
  • Trimethoprim, Sulfamethoxazole Drug Combination / pharmacology
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / metabolism*
  • beta-Lactams / pharmacokinetics
  • beta-Lactams / pharmacology

Substances

  • Anti-Infective Agents
  • Fluoroquinolones
  • Quinolones
  • beta-Lactams
  • Fosfomycin
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Nitrofurantoin