Effect of antibacterial agent PK/PD index on efficacy of lower urinary tract infection therapy

The individual pharmacological profile of an antimicrobial drug (AMP) is determined by its pharmacokinetic/pharmacodynamic properties and is referred to as the PK/PD profile. Based on the estimated PK/PD index, various types of antimicrobial activity were identified: concentration-dependent and time-dependent AMP. Fluoroquinolones are antimicrobial agents with a concentration-dependent effect, for which the peak concentration of the active substance is important to achieve a bactericidal effect. Along with the minimum inhibitory concentration, for assessing the microbiological efficacy of ciprofloxacin, an indicator of the minimum concentration preventing mutations, which reflects the presence of the “mutation selection window”, is important. The main obstacle to increasing bioavailability and the formation of maximum plasma concentrations of ciprofloxacin is a “narrow absorption window”. The original prolonged dosage form of ciprofloxacin 1000 mg for a single dose per day (Cifran® OD 1000 mg) is based on FDD technology: flotation, dispersion and diffusion. Due to the higher Cmax values created, the tablet form of the sustained release allows overcoming the “window of selection mutation” of the main uropathogens. The proven reduction in the frequency of therapeutic failures when using the ciprofloxacin 1000 mg dosing regimen 1 time per day is due to the possibility of slowing down the mutation rate and preventing the selection of resistant strains of uropathogens against the background of antimicrobial therapy, as well as increasing adherence to therapy.

pharmacokinetics, pharmacodynamics, antimicrobial resistance, fluoroquinolones, ciprofloxacin, dosage form, therapeutic efficacy, therapeutic failure