Pharmacokinetics and Pharmacodynamics of Antibiotics in Bone

This chapter reviews the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics in bone and presents methods that support optimized evidence-based selection of antibiotic dosage regimens. It presents an overview of the extent of bone penetration by antibiotic or antibiotic group. Bone penetration studies should report details on the chosen methods for sample preparation and analysis, and the recovery, bias, and precision. Once a population PK model for plasma and bone has been developed, it can be employed in Monte Carlo simulations to predict the expected concentration-time profiles for other than the studied dosage regimens. Trends in the extent of bone penetration among different groups of antibiotics have been found from a review of greater than 140 literature studies, such as typical average penetration of 0.3-1.2 for fluoroquinolones, 0.2-0.5 for linezolid, 0.1-0.3 for penicillins, and 0.1-0.5 for cephalosporins.