conc-dependent
aminoglycosides
fluroquinolones
daptomycin
metronidazole (against anaerobes)
conc-independent
b-lactams glycopeptides macrolides clindamycin tetracyclines linezolid
most correlated with Cmax/MIC
amionglycosides
fluroquinolones
most correlated with AUC/MIC
quinolones
aminoglycosides
glycopeptides
most corrlated with T>MIC
b-lactams glycopeptides macrolides clindamycin tetracyclines linezolid
dosing paradigm
b-lactams: higher frequency, prolonged infusions
vancomycin (AUC/MIC): flexible
fluoroquinolones (both): flexible, high dose
aminoglycosides (both): high dose, low frequency
gram negative only
enterococcal endocarditis exception (longer dose, high freq)
PK-PD indices
b-lactams aminoglycosides quinolones (conc) daptomycin (conc) tetracyclines (time) glucopeptides (time) macrolides (time)
b-lactam: Time above MIC
amino: Cmax/MIX
quinolones daptomycin tetracyclines glucopeptides macrolides:
AUC/MIC
then look at second layer