Importance and Role of Pharmacokinetics, Pharmacodynamics and Stability in Nonhospital, Community-Based Parenteral Antimicrobial Therapy

Several variables including the likely infecting organism, pharmacokinetic (PK) and pharmacodynamic factors (PD), and drug stability must be considered when selecting antimicrobials. The goal of antibiotic therapy is to provide adequate drug concentration at the site of infection long enough to eliminate the pathogen. Almost any antimicrobial can be used for outpatient therapy, but drugs with long half-lives are the best suited. The use of agents that can be administered once or twice daily minimized the disruption of daily activities and limited the number of intravenous line manipulations, lessening the potential for catheter-associated complications (1-3). Ceftriaxone (Rocephin, Hoffmann La Roche Limited, Mississauga, Ontario) and other cephalosporins have been the most common drugs reported in the literature (4). If the antibiotic must be given every 2, 4, or 6 h, it may become impractical to give at home without the aid of an infusion pump. Not all Canadian centres use pumps because they are complicated for patients to use and are expensive (1,5).