Pharmacodynamics: From Science to Practice

A joint symposium between ISAPand ICC (International Congress of Chemotherapy) held during the 21st International Congress of Chemotherapy (July 4th-7th, 1999)

co-organizers: M.N. Dudley (Montain View, CA) & O. Cars, Uppsala, Sweden

Summary of the meeting

The slides presented by the some of the speakers at this workshop are available on this site as "Web slide shows".  To view them, click on the title of the lectures.  These slides, which reflect the views of their authors and should not be taken as being endorsed by ISAP, are for information purposes only.  They cannot be reproduced or used for any form of  presentations without the autorization of their author and of ISAP. Please, contact the ISAP Webmaster for further information.

Patterns of killing of bacteria and fungi (Ian Gould, Aberdeen, UK)   Persistent and subinhibitory effects of antiinfectives on micro-organisms (Inga Odenholt, Malmö, Sweden)   Can animal models predict clinical results ? (Claude Carbon, Paris, France)   Continuous infusion of antibiotics in the clinic (J. E. Leggett, Providence, OR).

"Pharmacodynamics: from theory to practice" provided a good overview of the state of the art in the use of in vitro and in vivo methods for exploitation of pharmacological properties of antimicrobials. Ian Gould (Abedeen, UK) reviewed the patterns of bacterial killing in vitro and demonstrated the varied effects different classes of antimicrobials exert on target pathogens. He concluded that these properties are important to consider and go beyond the MIC in describing the full effect of antibiotics. Inga Odenholt (Malmö, Sweden) reviewed the persistent effects of antimicrobials on bacteria, and various metrics that have been used to describe the effects in vitro and in models of infection. Many agents exert prolonged antimicrobial effects in vitro and in vivo, and in particular postantibiotic sub-MIC effects contribute to prolonged action of certain beta-lactams against gram positive bacteria. Claude Carbon (Paris, France) reviewed the use of animal models of infection to select target dosage regimens in humans. Animal models, combined with human pharmacokinetic data,  can provide useful predictions of the efficacy of anticipated human regimens. Finally, James Legget (Portland, OR) reviewed available data on the use of continuous infusions of beta-lactam antibiotics in the management of human infection. Controlled trials can be difficult to conduct because of sparse pharmacokinetic data for older drugs to select proper infusion rates to achieve target exposure levels. Several trials, including one from their group, have demonstrated the feasibility and efficacy of this approach. Further studies in controlled settings are needed, but current results are promising

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