Medical Microbiology

200 3 GeneralBacteriology

Pharmacokinetics..........................................

Pharmacokineticscoverstheprinciplesofabsorption,distribution,andelimi-

nationofpharmaconsbythemacroorganism.Thereaderisreferredtostan-

dardtextbooksofpharmacologyfordetails.Thedosageanddosageinterval

recommendationsforantibacterialtherapytakeintoaccountthewidelydif-

feringpharmacokineticparametersofthedifferentanti-infectiveagents,

amongthem:

&Absorptionrateandspecificabsorptiontime

&Volumeofdistribution

&Proteinbinding

&Serum(blood)concentration

&Tissueconcentration

&Metabolization

&Elimination

SideEffects................................................

Treatmentwithanti-infectiveagentscancausesideeffects,resultingeither

fromnoncompliancewithimportanttherapeuticprinciplesorspecificpa-

tientreactivity.Onthewhole,suchsideeffectsareofminorsignificance.

&Toxiceffects.Theseeffectsarisefromdirectcellandtissuedamageinthe

macroorganism.Bloodconcentrationsofsomesubstancesmustthereforebe

monitoredduringtherapyifthereisariskofcumulationduetoinefficient

elimination(examples:aminoglycosides,vancomycin).

&Allergicreactions.Seep. 108 forpossiblemechanisms(example:peni-

cillinallergy).

&Biologicalsideeffects.Example:changeinoreliminationofnormalflora,

interferingwithitsfunctionasabeneficialcolonizer(seep.25).

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Kayser, Medical Microbiology © 2005 Thieme