Optimisation de l'antibiothérapie

Dose regimen selection in late-phase clinical trials of a successful antibiotics drug development is a crucial step allowing the individualisation of treatments and management of the permanent risk of resistance linked to the pressure of selection facing sub-therapeutic exposures. This article describes the main results published lately in the field of clinical pharmacokinetics, pharmacokinetics-pharmacodynamics studies, as well as in silico modelisation works (Monte Carlo simulations) that were conducted in an effort to maximize the probability of a positive clinical response to therapy and minimize the likelihood of exposure-related toxicity for several antibiotics in clinical studies. In the current circumstances of a lack for new antibiotics development, the application of these results would help avoid an efficiency failure situation for patients with severe and deep multiresistant bacteria infections.