WS04 The population PK/PD approach for a rational use of anti-infective drugs to minimize resistance

摘要

Objective Antimicrobial resistance is not only here, it is here to stay and it poses major threats to the effective use of antimicrobial drugs in humans and other animals. Nevertheless, a defeatist attitude is not acceptable. There is much that can and must be done to retard or prevent the emergence and spread of resistance. Clinicians and scientists from many disciplines have roles to play in combating resistance and we veterinary pharmacologists arguably have the most important role of all. As Schentag (1996) indicated 10 years ago, ''The design of appropriate dosage regimens may be the single most important contribution of clinical pharmacology to the resistance problem''. However, progress has not been rapid and as recently as 2003 Drusano commented, ''One area in which there is little investigation is the use of proper dosing to help prevent emergence of resistance'' and, again in 2005, Drusano et al. commented ''little attention has been focussed on delineating the correct dose to suppress the amplification of less susceptible mutant bacterial sub-populations''. In this Workshop we address, with the help of internationally recognised authorities, antimicrobial resistance in veterinary medicine, from the perspectives of basic mechanisms, epidemiology and pre-clinical and population PK-PD modelling in dosage design. In addition, we review prudent use, clinical aspects and the contribution of regulatory efforts to minimise the selection of resistant microorganisms.