THE ECONOMIC-POTENTIAL OF DUAL INDIVIDUALIZATION METHODOLOGIES

Cost-effective treatment of patients with bacterial infections can bes t be accomplished by facilitating a rapid response. Achieving a more r apid cure of the infection should result in reduced utilisation of hea lthcare resources. An innovative means of achieving a more rapid respo nse to antibacterial therapy has been termed dual individualisation. D ual individualisation allows for the simultaneous consideration of the pharmacokinetic interaction between an antibacterial agent and a pati ent, with the pharmacodynamic interaction between the antibacterial ag ent and the bacterial pathogen. Integrating the pharmacokinetic parame ter of area under the curve (AUC), with the pharmacodynamic measure of minimum inhibitory concentration (MIC) yields a ratio called the area under the inhibitory curve (AUIC). Clinical studies using dual indivi dualisation to achieve a target AUIC(24h) of 125-250 have been perform ed with cephalosporins and fluoroquinalones. Economic evaluation of th e results demonstrate that dual individualisation is cost-effective. D ual individualisation can be implemented in most practice settings usi ng existing clinical data. Use of a computer model allows for cost-eff ective calculation of AUIC(24h) without having to measure serum drug c oncentrations of bacterial MIC. By adjusting antibacterial regimens to achieve a target AUIC, optimisation of antibacterial therapy can be a chieved with resultant economic benefits.