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Clin Microbiol Infect. 2008 Jan;14 Suppl 1:166-8.

Breakpoints for extended-spectrum beta-lactamase-producing Enterobacteriacae: pharmacokinetic/pharmacodynamic considerations.

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Department of Medical Microbiology, Bristol Centre for Antimicrobial Research and Evaluation, University of Bristol and North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, UK.

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  • Clin Microbiol Infect. 2008 May;14 Suppl 5:21-4.


An understanding of antibacterial pharmacokinetics and pharmacodynamics is central to setting clinical breakpoints. It is important to understand any impact that a resistance mechanism may have on these basic drug properties. With extended-spectrum beta-lactamase (ESBL)-producing strains of Enterobacteriacae, it is known that MIC, and hence T>MIC, for beta-lactams predicts outcome. Therefore, pharmacodynamic modelling can be used to set breakpoints for ESBL-producing bacteria with beta-lactams.

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