[Pharmacokinetic effects of antibiotics on the development of bacterial resistance particularly in reference to azithromycin].

Antibiotics reduce the mortality from infectious diseases but not the prevalence of these diseases. Use, and often abuse, of antimicrobial agents encourages the evolution of bacteria toward resistance, often resulting in therapeutic failure. There are two factors which influence potential utility of a drug in a specific clinical situation. The first is the measure of potency of the antibiotic for the pathogen in question (minimal inhibitory concentration [MIC], minimal bactericidal concentration [MBC]). The second is whichever relationship between the concentration-time profile and potency of the antibiotic linked most robustly to clinical outcome (time above MIC or MBC [T > MIC or T > MBC]; Peak/MIC or MBC; area under the curve [AUC]/MIC or AUC/MBC). Herein the effects of pharmacokinetics of antimicrobials on the evolution of antimicrobial resistance with particular reference to azithromycin are considered.