Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Clinical Pharmacokinetics
Published in: Clinical Pharmacokinetics 4/2007

01-04-2007 | Review Article

Pharmacokinetic Characteristics of Antimicrobials and Optimal Treatment of Urosepsis

Authors: Dr Florian M. E. Wagenlehner, Wolfgang Weidner, Kurt G. Naber

Published in: Clinical Pharmacokinetics | Issue 4/2007

Login to get access

Abstract

Urosepsis accounts for approximately 25% of all sepsis cases and may develop from a community-acquired or nosocomial urinary tract infection (UTI). Nevertheless, the underlying UTI is almost exclusively a complicated one with involvement of the parenchymatous urogenital organs (e.g. kidneys, prostate) and mostly associated with any kind of obstructive uropathy. If urosepsis originates from a nosocomial infection, a broad spectrum of Gram-negative and Gram-positive pathogens have to be expected, which are often multiresistant.
In urosepsis, as in other types of sepsis, the severity of sepsis depends mostly upon the host response. The treatment of urosepsis follows the generally accepted rules of the ‘Surviving Sepsis’ campaign guidelines. Early normalisation of blood pressure and early adequate empirical antibacterial therapy with optimised dosing are equally important to meet the requirements of early goal-directed therapy. In most cases of urosepsis, early control of the infectious focus is possible and as important. Optimal supportive measures need to follow the early phase of resuscitation. To lower mortality from urosepsis, an optimal interdisciplinary approach between intensive care, anti-infective therapy and urology is essential, assisted by easy access to the necessary laboratory and imaging diagnostic procedures.
Although most antibacterials achieve high urinary concentrations, there are several unique features of complicated UTI, and thus urosepsis, that influence the activity of antibacterial substances: (i) renal pharmacokinetics differ in unilateral and bilateral renal impairment and in unilateral and bilateral renal obstruction; (ii) variations in pH may influence the activity of certain antibacterials; and (iii) biofilm infection is frequently found under these conditions, which may increase the minimal inhibitory concentrations (MIC) of the antibacterials at the site of infection by several hundred folds. Assessment of antibacterial pharmacodynamic properties in such situations should take into account not only the MIC as determined in vitro and the plasma concentrations of the free (unbound) drug, which are the guiding principles for many infections, but also the actual renal excretion and urinary bactericidal activity of the antibacterial substance. In the treatment of urosepsis, it is important to achieve optimal exposure to antibacterials both in plasma and in the urinary tract. The role of drugs with low renal excretion rates is therefore limited.
Since urosepsis quite often originates from catheter-associated UTI and urological interventions, optimal catheter care and optimal strategies to prevent nosocomial UTI may be able to reduce the frequency of urosepsis.
Literature
1.
Book M, Lehmann LE, Schewe JC, et al. Urosepsis: current therapy and diagnosis [in German]. Urologe A 2005; 44(4): 413–24PubMedCrossRef
2.
Brun-Buisson C. The epidemiology of the systemic inflammatory response. Intensive Care Med 2000; 26 Suppl. 1: S64–74PubMedCrossRef
3.
Martin GS, Mannino DM, Eaton S, et al. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003; 348(16): 1546–54PubMedCrossRef
4.
Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med 2003; 348(2): 138–50PubMedCrossRef
5.
Brun-Buisson C, Meshaka P, Pinton P, et al. EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 2004; 30(4): 580–8PubMedCrossRef
6.
Knaus WA, Sun X, Nystrom O, et al. Evaluation of definitions for sepsis. Chest 1992; 101(6): 1656–62PubMedCrossRef
7.
Rosser CJ, Bare RL, Meredith JW. Urinary tract infections in the critically ill patient with a urinary catheter. Am J Surg 1999; 177(4): 287–90PubMedCrossRef
8.
Menninger M. Urosepsis, Klinik, Diagnostik und Therapie. In: Hofstetter A, editor. Urogenitale Infektionen. Berlin, Heidelberg, New York: Springer, 1998: 521–8
9.
Wagenlehner FM, Weidner W, Naber KG. Emergence of antibiotic resistance amongst hospital-acquired urinary tract infections and pharmacokinetic/pharmacodynamic considerations. J Hosp Infect 2005; 60(3): 191–200PubMedCrossRef
10.
Wagenlehner F, Naber KG. Antibiotics and resistance of uropathogens. European Urology (Update Series) 2004; 2: 125–35
11.
Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis: the ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101(6): 1644–55PubMedCrossRef
12.
Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003; 31(4): 1250–6PubMedCrossRef
13.
Bone RC, Sprung CL, Sibbald WJ. Definitions for sepsis and organ failure. Crit Care Med 1992; 20(6): 724–6PubMedCrossRef
14.
15.
Poltorak A, He X, Smirnova I, et al. Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: mutations in Tlr4 gene. Science 1998; 282(5396): 2085–8PubMedCrossRef
16.
Opal SM, Huber CE. Bench-to-bedside review: Toll-like receptors and their role in septic shock. Crit Care 2002; 6(2): 125–36PubMedCrossRef
17.
Means TK, Golenbock DT, Fenton MJ. Structure and function of Toll-like receptor proteins. Life Sci 2000; 68(3): 241–58PubMedCrossRef
18.
Harbarth S, Holeckova K, Froidevaux C, et al. Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis. Am J Respir Crit Care Med 2001; 164(3): 396–402PubMed
19.
Naber KG, Madsen PO. Renal function during acute total ureteral occlusion and the role of the lymphatics: an experimental study in dogs. J Urol 1973; 109(3): 330–8PubMed
20.
Naber KG, Madsen PO, Maroske D, et al. Antibiotics and chemotherapeutics in renal lymph: an experimental study in dogs. Invest Urol 1976; 14(1): 23–7PubMed
21.
Naber K, Madsen PO, Bichler KH, et al. Determination of renal tissue levels of antibiotics [in German]. Infection 1973; 1: 208–13PubMedCrossRef
22.
Jaenike JR. The renal response to ureteral obstruction: a model for the study of factors which influence glomerular filtration pressure. J Lab Clin Med 1970; 76(3): 373–82PubMed
23.
Gulmi FAFD, Vaughan Jr ED. Pathophysiology of urinary tract obstruction. In: Walsh PC, Retik AB, Vaughan ED, et al., editors. Campbell’s urology. 8th ed. Philadelphia: Saunders, 2002: 411–62
24.
Naber KG, Kuni H. Renale Pharmakokinetik. Hahnenklee-Symposium ‘Pyelonephriti’; 1976 May 20–21; Roche, Basel, 271-85
25.
Bricker NS, Morrin PA, Kime Jr SW. The pathologic physiology of chronic Bright’s disease: an exposition of the ‘intact nephron hypothesi’. Am J Med 1960; 28: 77–98PubMedCrossRef
26.
27.
28.
Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345(19): 1368–77PubMedCrossRef
29.
30.
Annane D, Sebille V, Charpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288(7): 862–71PubMedCrossRef
31.
van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med 2001; 345(19): 1359–67PubMedCrossRef
32.
Bernard GR, Ely EW, Wright TJ, et al. Safety and dose relationship of recombinant human activated protein C for coagulopathy in severe sepsis. Crit Care Med 2001; 29(11): 2051–9PubMedCrossRef
33.
Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2004; 32(3): 858–73PubMedCrossRef
34.
Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis campaign guidelines for management of severe sepsis and septic shock. Intensive Care Med 2004; 30(4): 536–55PubMedCrossRef
35.
Yoshimura K, Utsunomiya N, Ichioka K, et al. Emergency drainage for urosepsis associated with upper urinary tract calculi. J Urol 2005; 173(2): 458–62PubMedCrossRef
36.
Paterson DL. Restrictive antibiotic policies are appropriate in intensive care units. Crit Care Med 2003; 31(1 Suppl.): S25–8PubMedCrossRef
37.
38.
Wagenlehner FM, Krcmery S, Held C, et al. Epidemiological analysis of the spread of pathogens from a urological ward using genotypic, phenotypic and clinical parameters. Int J Antimicrob Agents 2002; 19(6): 583–91PubMedCrossRef
39.
Kreger BE, Craven DE, McCabe WR. Gram-negative bacteremia: IV. Re-evaluation of clinical features and treatment in 612 patients. Am J Med 1980; 68(3): 344–55PubMedCrossRef
40.
Kreger BE, Craven DE, Carling PC, et al. Gram-negative bacteremia: III. Reassessment of etiology, epidemiology and ecology in 612 patients. Am J Med 1980; 68(3): 332–43PubMedCrossRef
41.
Elhanan G, Sarhat M, Raz R. Empiric antibiotic treatment and the misuse of culture results and antibiotic sensitivities in patients with community-acquired bacteraemia due to urinary tract infection. J Infect 1997; 35(3): 283–8PubMedCrossRef
42.
Kollef MH, Ward S. The influence of mini-BAL cultures on patient outcomes: implications for the antibiotic management of ventilator-associated pneumonia. Chest 1998; 113(2): 412–20PubMedCrossRef
43.
Luna CM, Vujacich P, Niederman MS, et al. Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia. Chest 1997; 111(3): 676–85PubMedCrossRef
44.
45.
46.
Frimodt-Møller N. How predictive is PK/PD for antibacterial agents? Int J Antimicrob Agents 2002; 19(4): 333–9PubMedCrossRef
47.
Frimodt-Møller N. Correlation between pharmacokinetic/pharmacodynamic parameters and efficacy for antibiotics in the treatment of urinary tract infection. Int J Antimicrob Agents 2002; 19(6): 546–53PubMedCrossRef
48.
Hvidberg H, Struve C, Krogfelt KA, et al. Development of a long-term ascending urinary tract infection mouse model for antibiotic treatment studies. Antimicrob Agents Chemother 2000; 44(1): 156–63PubMedCrossRef
49.
Naber KG. Which fluoroquinolones are suitable for the treatment of urinary tract infections? Int J Antimicrob Agents 2001; 17(4): 331–41PubMedCrossRef
50.
Mulvey MA, Schilling JD, Hultgren SJ. Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection. Infect Immun 2001; 69(7): 4572–9PubMedCrossRef
51.
Ivanyi B, Rumpelt HJ, Thoenes W. Acute human pyelonephritis: leukocytic infiltration of tubules and localization of bacteria. Virchows Arch A Pathol Anat Histopathol 1988; 414(1): 29–37PubMedCrossRef
52.
Deguchi T, Kuriyama M, Maeda S, et al. Electron microscopic study of acute retrograde pyelonephritis in mice. Urology 1990; 35(5): 423–7PubMedCrossRef
53.
Chippendale GR, Warren JW, Trifillis AL, et al. Internalization of Proteus mirabilis by human renal epithelial cells. Infect Immun 1994; 62(8): 3115–21PubMed
54.
Anderson GG, Martin SM, Hultgren SJ. Host subversion by formation of intracellular bacterial communities in the urinary tract. Microbes Infect 2004; 6(12): 1094–101PubMedCrossRef
55.
Justice SS, Hung C, Theriot JA, et al. Differentiation and developmental pathways of uropathogenic Escherichia coli in urinary tract pathogenesis. Proc Natl Acad Sci U S A 2004; 101(5): 1333–8PubMedCrossRef
56.
Kumon H. Management of biofilm infections in the urinary tract. World J Surg 2000; 24(10): 1193–6PubMedCrossRef
57.
Nickel JC, Olson ME, Costerton JW. Rat model of experimental bacterial prostatitis. Infection 1991; 19 Suppl. 3: S126–30PubMedCrossRef
58.
Zogaj X, Bokranz W, Nimtz M, et al. Production of cellulose and curli fimbriae by members of the family Enterobacteriaceae isolated from the human gastrointestinal tract. Infect Immun 2003; 71(7): 4151–8PubMedCrossRef
59.
Sabbuba NA, Mahenthiralingam E, Stickler DJ. Molecular epidemiology of Proteus mirabilis infections of the catheterized urinary tract. J Clin Microbiol 2003; 41(11): 4961–5PubMedCrossRef
60.
Jansen AM, Lockatell V, Johnson DE, et al. Mannose-resistant Proteus-like fimbriae are produced by most Proteus mirabilis strains infecting the urinary tract, dictate the in vivo localization of bacteria, and contribute to biofilm formation. Infect Immun 2004; 72(12): 7294–305PubMedCrossRef
61.
Ando E, Monden K, Mitsuhata R, et al. Biofilm formation among methicillin-resistant Staphylococcus aureus isolates from patients with urinary tract infection. Acta Med Okayama 2004; 58(4): 207–14PubMed
62.
Debbia EA, Dolcino M, Marchese A, et al. Enhanced biofilm-production in pathogens isolated from patients with rare metabolic disorders. New Microbiol 2004; 27(4): 361–7PubMed
63.
Seno Y, Kariyama R, Mitsuhata R, et al. Clinical implications of biofilm formation by Enterococcus faecalis in the urinary tract. Acta Med Okayama 2005; 59(3): 79–87PubMed
64.
Bokranz W, Wang X, Tschape H, et al. Expression of cellulose and curli fimbriae by Escherichia coli isolated from the gastrointestinal tract. J Med Microbiol 2005; 54 (Pt12): 1171–82CrossRef
65.
Goto T, Nakame Y, Nishida M, et al. In vitro bactericidal activities of beta-lactamases, amikacin, and fluoroquinolones against Pseudomonas aeruginosa biofilm in artificial urine. Urology 1999; 53(5): 1058–62PubMedCrossRef
66.
Goto T, Nakame Y, Nishida M, et al. Bacterial biofilms and catheters in experimental urinary tract infection. Int J Antimicrob Agents 1999; 11(3–4): 227–31, discussion 237-9PubMedCrossRef
67.
Scheid WM. Maintaining fluoroquinolone class efficacy: review of influencing factors. Emerg Infect Dis 2003; 9(1): 1–9CrossRef
68.
Pea F, Pavan F, Di Quai E, et al. Urinary pharmacokinetics and theoretical pharmacodynamics of intravenous levofloxacin in intensive care unit patients treated with 500mg b.i.d. for ventilator-associated pneumonia. J Chemother 2003; 15(6): 563–7PubMed
69.
Hansen GT, Blondeau JM. Comparison of the minimum inhibitory, mutant prevention and minimum bactericidal concentrations of ciprofloxacin, levofloxacin and garenoxacin against enteric Gram-negative urinary tract infection pathogens. J Chemother 2005; 17(5): 484–92PubMed
70.
Hansen GT, Zhao X, Drlica K, et al. Mutant prevention concentration for ciprofloxacin and levofloxacin with Pseudomonas aeruginosa. Int J Antimicrob Agents 2006; 27(2): 120–4PubMedCrossRef
71.
Fang GD, Brennen C, Wagener M, et al. Use of ciprofloxacin versus use of aminoglycosides for therapy of complicated urinary tract infection: prospective, randomized clinical and pharmacokinetic study. Antimicrob Agents Chemother 1991; 35(9): 1849–55PubMedCrossRef
72.
Peters HJ. Comparison of intravenous ciprofloxacin and mezlocillin in treatment of complicated urinary tract infection. Eur J Clin Microbiol 1986; 5(2): 253–5PubMedCrossRef
73.
Peters HJ. Sequential therapy with ofloxacin in complicated urinary tract infections: a randomized comparative study with ciprofloxacin. Infection 1992; 20(3): 172–3PubMedCrossRef
74.
Naber KG, di Silverio F, Geddes A, et al. Comparative efficacy of sparfloxacin versus ciprofloxacin in the treatment of complicated urinary tract infection. J Antimicrob Chemother 1996; 37 Suppl. A: 135–44PubMedCrossRef
75.
Mombelli G, Pezzoli R, Pinoja-Lutz G, et al. Oral vs intravenous ciprofloxacin in the initial empirical management of severe pyelonephritis or complicated urinary tract infections: a prospective randomized clinical trial. Arch Intern Med 1999; 159(1): 53–8PubMedCrossRef
76.
McCue JD. Complicated, recurrent, and geriatric UTI. Contemp Urol 1995; Suppl.: 10-7
77.
McCue JD, Gaziano P, Orders D. A randomised controlled trial of ofloxacin 200mg 4 times daily or twice daily vs ciprofloxacin 500mg twice daily in elderly nursing home patients with complicated UTI. Drugs 1995; 49 Suppl. 2: 368–73PubMedCrossRef
78.
Whitby M, Angus L, Nimmo G, et al. Complicated urinary infection in spinal injury patients: fleroxacin compared with ciprofloxacin. Chemotherapy 1996; 42(6): 468–72PubMedCrossRef
79.
Pisani E, Bartoletti R, Trinchieri A, et al. Lomefloxacin versus ciprofloxacin in the treatment of complicated urinary tract infections: a multicenter study. J Chemother 1996; 8(3): 210–3PubMed
80.
Raz R, Naber KG, Raizenberg C, et al. Ciprofloxacin 250mg twice daily versus ofloxacin 200mg twice daily in the treatment of complicated urinary tract infections in women. Eur J Clin Microbiol Infect Dis 2000; 19(5): 327–31PubMedCrossRef
81.
Krcmery S, Naber KG. Ciprofloxacin once versus twice daily in the treatment of complicated urinary tract infections. German Ciprofloxacin UTI Study Group. Int J Antimicrob Agents 1999; 11(2): 133–8PubMedCrossRef
82.
Frankenschmidt A, Naber KG, Bischoff W, et al. Once-daily fleroxacin versus twice-daily ciprofloxacin in the treatment of complicated urinary tract infections. J Urol 1997; 158(4): 1494–9PubMedCrossRef
83.
Cox CE, Marbury TC, Pittman WG, et al. A randomized, double-blind, multicenter comparison of gatifloxacin versus ciprofloxacin in the treatment of complicated urinary tract infection and pyelonephritis. Clin Ther 2002; 24(2): 223–36PubMedCrossRef
84.
Talan DA, Klimberg IW, Nicolle LE, et al. Once daily, extended release ciprofloxacin for complicated urinary tract infections and acute uncomplicated pyelonephritis. J Urol 2004; 171 (2 Pt1): 734–9CrossRef
85.
Matsumoto T, Kumazawa J, Ueda S, et al. Treatment of complicated urinary tract infections with ofloxacin following an aminoglycoside. Chemotherapy 1991; 37 Suppl. 1: 60–7PubMedCrossRef
86.
Schalkhauser K. Comparison of i.V. ofloxacin and piperacillin in the treatment of complicated urinary tract infections. J Antimicrob Chemother 1990; 26 Suppl. D: 93–7PubMedCrossRef
87.
Cox CE. Comparison of intravenous fleroxacin with ceftazidime for treatment of complicated urinary tract infections. Am J Med 1993; 94(3A): 118S–25SPubMed
88.
Pittman W, Moon JO, Hamrick Jr LC, et al. Randomized double-blind trial of high- and low-dose fleroxacin versus norfloxacin for complicated urinary tract infection. Am J Med 1993; 94(3A): 101S–4SPubMed
89.
Gelfand MS, Simmons BP, Craft RB, et al. A sequential study of intravenous and oral fleroxacin in the treatment of complicated urinary tract infection. Am J Med 1993; 94(3A): 126S–30SPubMed
90.
Giamarellou H. Fleroxacin in complicated urinary tract infections. Chemotherapy 1996; 42 Suppl. 1: 17–27PubMedCrossRef
91.
Nicolle LE, Louie TJ, Dubois J, et al. Treatment of complicated urinary tract infections with lomefloxacin compared with that with trimethoprim-sulfamethoxazole. Antimicrob Agents Chemother 1994; 38(6): 1368–73PubMedCrossRef
92.
Hoepelman IM, Havinga WH, Benne RA, et al. Safety and efficacy of lomefloxacin versus norfloxacin in the treatment of complicated urinary tract infections. Eur J Clin Microbiol Infect Dis 1993; 12(5): 343–7PubMedCrossRef
93.
Gottlieb PL. Comparison of enoxacin versus trimethoprim-sulfamethoxazole in the treatment of patients with complicated urinary tract infection. Clin Ther 1995; 17(3): 493–502PubMedCrossRef
94.
Klimberg IW, Cox CE, 2nd, et al. A controlled trial of levofloxacin and lomefloxacin in the treatment of complicated urinary tract infection. Urology 1998; 51(4): 610–5PubMedCrossRef
95.
Peng MY. Randomized, double-blind, comparative study of levofloxacin and ofloxacin in the treatment of complicated urinary tract infections. J Microbiol Immunol Infect 1999; 32(1): 33–9PubMed
96.
Lubasch A, Keller I, Borner K, et al. Comparative pharmacokinetics of ciprofloxacin, gatifloxacin, grepafloxacin, levofloxacin, trovafloxacin, and moxifloxacin after single oral administration in healthy volunteers. Antimicrob Agents Chemother 2000; 44(10): 2600–3PubMedCrossRef
97.
Naber K. Antibacterial activity of antibacterial agents in urine: an overview of applied methods. In: Bergan T, editor. Urinary tract infections. Basel, Freiburg, Paris, London, New York: Karger, 1997: 74–83CrossRef
98.
Wagenlehner F, Tischmeyer U, Kinzig-Schippers M, Sörgel F, Wagenlehner C, Naber KG. Plasma concentrations, urinary excretion and bactericidal activity of ciproloxacin XR (1,000mg) versus levofloxacin (500mg) in healthy volunteers receiving a single oral dose. 24th International Congress of Chemotherapy; 2005 June 4–6; Manila
99.
Wagenlehner FM, Kinzig-Schippers M, Tischmeyer U, et al. Pharmacokinetics of ciprofloxacin XR (1000mg) versus levofloxacin (500mg) in plasma and urine of male and female healthy volunteers receiving a single oral dose. Int J Antimicrob Agents 2006; 27(1): 7–14PubMedCrossRef
100.
Boy D, Well M, Kinzig-Schippers M, et al. Urinary bactericidal activity, urinary excretion and plasma concentrations of gatifloxacin (400 mg) versus ciprofloxacin (500 mg) in healthy volunteers after a single oral dose. Int J Antimicrob Agents 2004; 23 Suppl. 1: S6–16PubMedCrossRef
101.
Stein GE, Schooley S. Urinary concentrations and bactericidal activities of newer fluoroquinolones in healthy volunteers. Int J Antimicrob Agents 2004; 24(2): 168–72PubMedCrossRef
102.
Wagenlehner FM, Kinzig-Schippers M, Tischmeyer U, et al. Urinary bactericidal activity of extended-release ciprofloxacin (1,000 milligrams) versus levofloxacin (500 milligrams) in healthy volunteers receiving a single oral dose. Antimicrob Agents Chemother 2006; 50(11): 3947–9PubMedCrossRef
103.
Allen A, Bygate E, Oliver S, et al. Pharmacokinetics and tolerability of gemifloxacin (SB-265805) after administration of single oral doses to healthy volunteers. Antimicrob Agents Chemother 2000; 44(6): 1604–8PubMedCrossRef
104.
Aminimanizani A, Beringer P, Jelliffe R. Comparative pharmacokinetics and pharmacodynamics of the newer fluoroquinolone antibacterials. Clin Pharmacokinet 2001; 40(3): 169–87PubMedCrossRef
105.
Vincent J, Venitz J, Teng R, et al. Pharmacokinetics and safety of trovafloxacin in healthy male volunteers following administration of single intravenous doses of the prodrug, alatrofloxacin. J Antimicrob Chemother 1997; 39 Suppl. B: 75–80PubMedCrossRef
106.
Richard GA, Klimberg IN, Fowler CL, et al. Levofloxacin versus ciprofloxacin versus lomefloxacin in acute pyelonephritis. Urology 1998; 52(1): 51–5PubMedCrossRef
107.
Naber KG, Bartnicki A, Bischoff W, et al. Gatifloxacin 200mg or 400mg once daily is as effective as ciprofloxacin 500mg twice daily for the treatment of patients with acute pyelonephritis or complicated urinary tract infections. Int J Antimicrob Agents 2004; 23 Suppl. 1: S41–53PubMedCrossRef
108.
109.
110.
Persky L, Liesen D, Yangco B. Reduced urosepsis in a veterans’ hospital. Urology 1992; 39(5): 443–5PubMedCrossRef
Metadata
Title
Pharmacokinetic Characteristics of Antimicrobials and Optimal Treatment of Urosepsis
Authors
Dr Florian M. E. Wagenlehner
Wolfgang Weidner
Kurt G. Naber
Publication date
01-04-2007
Publisher
Springer International Publishing
Published in
Clinical Pharmacokinetics / Issue 4/2007
Print ISSN: 0312-5963
Electronic ISSN: 1179-1926
DOI
https://doi.org/10.2165/00003088-200746040-00003

Other articles of this Issue 4/2007

Clinical Pharmacokinetics 4/2007 Go to the issue

Original Research Article

Population Pharmacokinetics of the BEACOPP Polychemotherapy Regimen in Hodgkin’s Lymphoma and its Effect on Myelotoxicity

Original Research Article

Effect of Time, Injury, Age and Ethanol on Interpatient Variability in Valproic Acid Pharmacokinetics after Traumatic Brain Injury

Original Research Article

Safety, Pharmacokinetics and Pharmocodynamics of Recombinant Human Porphobilinogen Deaminase in Healthy Subjects and Asymptomatic Carriers of the Acute Intermittent Porphyria Gene Who Have Increased Porphyrin Precursor Excretion

Leading Article

The Role of Pharmacogenetics in the Metabolism of Antiepileptic Drugs

Original Research Article

Tolerability, Safety and Pharmacokinetics of the FGLL Peptide, a Novel Mimetic of Neural Cell Adhesion Molecule, Following Intranasal Administration in Healthy Volunteers

Review Article

The Clinical Pharmacokinetics of Escitalopram