Clinical Relevance of Bacteriostatic versus Bactericidal Mechanisms of Action in the Treatment of Gram-Positive Bacterial Infections

Pankey, G. A.; Sabath, L. D.
March 2004
Clinical Infectious Diseases;3/15/2004, Vol. 38 Issue 6, p864
Academic Journal
The distinction between bactericidal and bacteriostatic agents appears to be clear according to the in vitro definition, but this only applies under strict laboratory conditions and is inconsistent for a particular agent against all bacteria. The distinction is more arbitrary when agents are categorized in clinical situations. The supposed superiority of bactericidal agents over bacteriostatic agents is of little relevance when treating the vast majority of infections with gram-positive bacteria, particularly in patients with uncomplicated infections and noncompromised immune systems. Bacteriostatic agents (e.g., chloramphenicol, clindamycin, and linezolid) have been effectively used for treatment of endocarditis, meningitis, and osteomyelitis—indications that are often considered to require bactericidal activity. Although bacteriostatic/bactericidal data may provide valuable information on the potential action of antibacterial agents in vitro, it is necessary to combine this information with pharmacokinetic and pharmacodynamic data to provide more meaningful prediction of efficacy in vivo. The ultimate guide to treatment of any infection must be clinical outcome.


Related Articles

  • Population pharmacokinetic and pharmacodynamic modeling of norvancomycin. Zhang, J.; Zhang, Y.; Shi, Y.; Rui, J.; Yu, J.; Cao, G.; Wu, J. // European Journal of Clinical Microbiology & Infectious Diseases;Apr2008, Vol. 27 Issue 4, p275 

    In this paper, population pharmacokinetics (PPK) and pharmacodynamics of norvancomycin in patients were investigated. The studied dataset was derived from 146 patients with confirmed or suspected gram-positive bacterial infections, as well as 20 healthy volunteers. A PPK model was developed and...

  • Dalbavancin: A new lipoglycopeptide antibiotic. Bailey, Jennifer; Summers, Kelly M. // American Journal of Health-System Pharmacy;4/1/2008, Vol. 65 Issue 7, p599 

    Purpose. The activity, pharmacokinetics, pharmacodynamics, efficacy, safety, and formulary considerations of dalbavancin are reviewed. Summary. Dalbavancin is a novel second-generation lipoglycopeptide antimicrobial with unique pharmacokinetics and excellent activity against resistant...

  • Pharmacological Issues of Linezolid. Di Paolo, Antonello; Malacarne, Paolo; Guidotti, Emanuele; Danesi, Romano; Del Tacca, Mario // Clinical Pharmacokinetics;2010, Vol. 49 Issue 7, p439 

    Linezolid is the first oxazolidinone agent introduced into clinical practice for use against Gram-positive bacteria that are resistant to β-lactams and glycopeptides, including methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). An...

  • The Discovery of Linezolid, the First Oxazolidinone Antibacterial Agent. Ford, C.W.; Zurenko, G.E.; Barbachyn, M.R. // Current Drug Targets - Infectious Disorders;Aug2001, Vol. 1 Issue 2, p181 

    The emergence of new antibiotic-resistance in the significant Gram-positive pathogens in the last decade created a substantial medical need for new classes of antibacterial agents. Pharmacia Corporation scientists initiated a discovery research program in oxazolidinone chemistry and biology....

  • Comparison of in vitro susceptibilities of Gram-positive cocci isolated from ocular infections against the second and fourth generation quinolones at a tertiary eye care centre in South India. Reddy, A. K.; Garg, P.; Alam, M. R.; Gopinathan, U.; Sharma, S.; Krishnaiah, S. // Eye;Jan2010, Vol. 24 Issue 1, p170 

    PurposeTo compare the in vitroantimicrobial susceptibilities of Gram-positive cocci isolated from the ocular infections to the second and fourth generation fluoroquinolones at a tertiary eye care centre in south India.MethodsA retrospective review of microbiology records at LV Prasad eye...

  • Quinupristin/Dalfopristin: A Review of its Use in the Management of Serious Gram-Positive Infections. Lamb, H.M.; Figgitt, D.P.; Faulds, D. // Drugs;Dec1999, Vol. 58 Issue 6, p1061 

    Quinupristin/dalfopristin is the first parenteral streptogramin antibacterial agent, and is a 30 : 70 (w/w) ratio of 2 semisynthetic pristinamycin derivatives. The combination has inhibitory activity against a broad range of Gram-positive bacteria including methicillin-resistant staphylococci,...

  • Bacteriostatic and Bactericidal Activities of Aspilia mossambicensis, Ocimum gratissimum and Toddalia asiatica Extracts on Selected Pathogenic Bacteria. Munyendo, W. L. L.; Orwa, J. A.; Rukunga, G. M.; Bii, C. C. // Research Journal of Medicinal Plant;Dec2011, Vol. 5 Issue 6, p717 

    Aspilia mossambicensis (Oliv.) Wild, Ocimum gratissimum (L.) Labiatae. and Toddalia asiatica (L.) Lam. (Rutaceae) were investigated with an overall aim of identifying and evaluating the bioactive antibacterial agents. Hexane, ethyl acetate and methanol realized yields of the range 0.5% Ocimum...

  • Dalbavancin. Anderson, Vanessa R.; Keating, Gillian M. // Drugs;2008, Vol. 68 Issue 5, p639 

    â–´ Dalbavancin is a semisynthetic glycopeptide antibacterial agent that is active against Gram-positive bacteria associated with complicated skin and skin structure infections (cSSSIs). It is administered as a two-dose regimen intravenously infused over 30 minutes once...

  • Pharmacokinetics and Pharmacodynamics of Fluoroquinolones. Turnidge, J. // Drugs;Dec1999 Supplement 2, Vol. 58 Issue 6, p29 

    The fluoroquinolones have moderate to excellent bioavailability, moderate to long elimination half-lives (50 to 98%) and volumes of distribution >1.5 L/kg. There is considerable variation in elimination pattern between fluoroquinolone agents, ranging from predominant renal excretion to extensive...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics