PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance

Antimicrobial resistance (AMR) poses a critical global health threat, necessitating the optimal use of existing antibiotics. Pharmacokinetic/pharmacodynamic (PK/PD) principles provide a scientific framework for optimizing antimicrobial therapy, particularly to respond to evolving resistance patterns...

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Main Authors: Tetsushu Onita, Noriyuki Ishihara, Takahisa Yano
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Antibiotics
Subjects:
Online Access:https://www.mdpi.com/2079-6382/14/1/92
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author Tetsushu Onita
Noriyuki Ishihara
Takahisa Yano
author_facet Tetsushu Onita
Noriyuki Ishihara
Takahisa Yano
author_sort Tetsushu Onita
collection DOAJ
description Antimicrobial resistance (AMR) poses a critical global health threat, necessitating the optimal use of existing antibiotics. Pharmacokinetic/pharmacodynamic (PK/PD) principles provide a scientific framework for optimizing antimicrobial therapy, particularly to respond to evolving resistance patterns. This review examines PK/PD strategies for antimicrobial dosing optimization, focusing on three key aspects. First, we discuss the importance of drug concentration management for enhancing efficacy while preventing toxicity, considering various patient populations, including pediatric and elderly patients with their unique physiological characteristics. Second, we analyze different PK modeling approaches: the classic top-down approach exemplified by population PK analysis, the bottom-up approach represented by physiologically based PK modeling, and hybrid models combining both approaches for enhanced predictive performance. Third, we explore clinical applications, including nomogram-based dosing strategies, Bayesian estimation, and emerging artificial intelligence applications, for real-time dose optimization. Critical challenges in implementing PK/PD simulation are addressed, particularly the selection of appropriate PK models, the optimization of PK/PD indices, and considerations concerning antimicrobial concentrations at infection sites. Understanding these principles and challenges is crucial for optimizing antimicrobial therapy and combating AMR through improved dosing strategies.
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spelling doaj-art-a78c61e3df1d48deabf5507f8e34fe852025-01-24T13:18:57ZengMDPI AGAntibiotics2079-63822025-01-011419210.3390/antibiotics14010092PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial ResistanceTetsushu Onita0Noriyuki Ishihara1Takahisa Yano2Department of Pharmacy, Shimane University Hospital, 89-1 Enya, Izumo 693-8501, Shimane, JapanDepartment of Pharmacy, Shimane University Hospital, 89-1 Enya, Izumo 693-8501, Shimane, JapanDepartment of Pharmacy, Shimane University Hospital, 89-1 Enya, Izumo 693-8501, Shimane, JapanAntimicrobial resistance (AMR) poses a critical global health threat, necessitating the optimal use of existing antibiotics. Pharmacokinetic/pharmacodynamic (PK/PD) principles provide a scientific framework for optimizing antimicrobial therapy, particularly to respond to evolving resistance patterns. This review examines PK/PD strategies for antimicrobial dosing optimization, focusing on three key aspects. First, we discuss the importance of drug concentration management for enhancing efficacy while preventing toxicity, considering various patient populations, including pediatric and elderly patients with their unique physiological characteristics. Second, we analyze different PK modeling approaches: the classic top-down approach exemplified by population PK analysis, the bottom-up approach represented by physiologically based PK modeling, and hybrid models combining both approaches for enhanced predictive performance. Third, we explore clinical applications, including nomogram-based dosing strategies, Bayesian estimation, and emerging artificial intelligence applications, for real-time dose optimization. Critical challenges in implementing PK/PD simulation are addressed, particularly the selection of appropriate PK models, the optimization of PK/PD indices, and considerations concerning antimicrobial concentrations at infection sites. Understanding these principles and challenges is crucial for optimizing antimicrobial therapy and combating AMR through improved dosing strategies.https://www.mdpi.com/2079-6382/14/1/92pharmacokineticspharmacodynamicsantimicrobial resistancepopulation modelingtherapeutic drug monitoringdose optimization
spellingShingle Tetsushu Onita
Noriyuki Ishihara
Takahisa Yano
PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance
Antibiotics
pharmacokinetics
pharmacodynamics
antimicrobial resistance
population modeling
therapeutic drug monitoring
dose optimization
title PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance
title_full PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance
title_fullStr PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance
title_full_unstemmed PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance
title_short PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance
title_sort pk pd guided strategies for appropriate antibiotic use in the era of antimicrobial resistance
topic pharmacokinetics
pharmacodynamics
antimicrobial resistance
population modeling
therapeutic drug monitoring
dose optimization
url https://www.mdpi.com/2079-6382/14/1/92
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