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January 14, 1998

Antibiotic Dosing—Does One Size Fit All?

Author Affiliations

From the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, NY.

JAMA. 1998;279(2):159-160. doi:10.1001/jama.279.2.159

In this issue of THE JOURNAL, Preston and colleagues1 argue that pharmacokinetic and pharmacodynamic modeling applied prospectively to a clinical trial of a fluoroquinolone antibiotic aids in understanding the efficacy and safety of therapy. The investigators used modeling to link bacterial eradication to the individual minimum inhibitory concentration (MIC) values of the bacteria, and the individual serum concentrations (ie, peak concentration or the area under the curve [AUC]) of the antibiotic in the treated patient. The article presents considerable evidence that the prospective use of these modeling methods in the course of a multicenter antibiotic trial can identify a dose that will ensure efficacy and can predict when a regimen will not work or will select resistant subpopulations of organisms.