Farmakokinetikai/farmakodinámiai modellekre alapozott antibakteriális terápia a kisállatgyógyászatban – 1. rész Irodalmi összefoglaló

Abstract

The antimicrobial resistance (AMR) is one of the most threatening problems of human health. In both public and animal health, multi-drug resistant (MDR) bacterial strains are increasingly emerging, which results in difficulties in the antimicrobial therapy. Until now, only the importance of farm animals has been emphasized in the context of AMR, but more recently it was shown that companion animals can also play a major role in its spread. The pharmacokinetic/pharmacodynamic (PK/PD) analysis of antibiotics is an efficient tool that can contribute to the reduction of the spread of resistant pathogens. It provides exact data, according to which the optimal dose and dosing interval can be selected to ensure a safe and effective use of antibiotics and reduce the chance of the evolutionary selection of antibiotic-resistant isolates of bacteria. As a result, the negative impact and the pressure on human health can be reduced. The authors outline below the resistance threats posed by the close contact between humans and companion animals, pointing out at the indirect and direct effects of spreading resistance and highlighting the most important multi-drug resistant (MDR) bacterial species that pose a public health risk. Furthermore, they summarise the key points of PK/PD analysis, covering the three main PK/PD indices (%T>MIC, Cmax/MIC, AUC/ MIC), the most important PK parameters (Cmax, tmax, t1/2, AUC, F, Cl, MRT) and the minimum inhibitory concentration (MIC) used in susceptibility testing. Finally, the pharmacokinetic and pharmacodynamic data on βlactam antibiotics in companion animals, available in the literature are presented, in an attempt to highlight the correlations that may facilitate the prudent antibiotic use. The authors also present the differences in PK parameters of the respective substances between dogs and cats through publications in the literature.