Many different types of antibacterial agents have been developed and used clinically. Efficacy is evaluated on the basis of the antibacterial activity of the agent, the concentration reached in infected tissues, and the frequence and type of side effects. However, with the recent increases in resistant bacteria and compromised hosts, it has become necessary to devise administration methods that obtain maximum effects with the minimum dosage of antibacterial agents.
For administration of the most appropriate antibacterial agents, it is necessary to study both the pharmacodynamics, (i. e., the interaction between drug and microorganism) and the pharmacokinetics, (i. e., the behavior of the drug in the body).
The usefulness of the postantibiotic effect (PAE), a pharmacodynamic parameter, was evaluated in patients with otorrhea and chronic otitis media.
PAE is defined as an inhibitory effect on the growth of microorganisms which persists after brief contact with the antibacterial agent. In the present study, Levofloxacin (LVFX), a quinoline that has a PAE, was tested. The subjects were 42 patients who were divided into three groups: a 400mg b. i. d group (n=14), a 200mg daily group (n=13), and a 200mg b. i. d. group (n=15).
Good clinical efficacy (including both markedly effective and effective cases) was obtained in the 400mg b. i. d group and the 200mg daily group.
The bacteriological efficacy as shown by the bacterial eradication was highest in the 400mg b. i. d group, followed by the 200mg daily group and the 200mg b. i. d group.
Antibiotic usefulness was higher in the 400mg b. i. d group and the 200mg daily group. It was concluded that, when quinolones are administered, consideration should be given to the PAE and to increasing the dose given each time when appropriate.
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