INTRACELLULAR CONCENTRATIONS OF ANTIBACTERIAL AGENTS AND RELATED CLINICAL IMPLICATIONS

Intracellular penetration, accumulation and disposition of antibacteri al agents is crucial for effective treatment of infections caused by i ntracellular bacteria. Intracellular concentrations and locations of b oth antibacterials and bacteria remain poorly understood and further r esearch is needed to establish the importance of these concepts. For e xample, concepts that have been shown to be important outcome predicto rs when applied to concentrations of antibacterial agents in the serum include: (i) the effect of the peak antibacterial serum concentration to minimum concentration inhibitory to 90% of organisms (MIC(90)) for bacteria; (ii) the effect of length of time the serum antibacterial c oncentration remains above the MIC(90) curve; or (iii) the area under the MIC(90) curve, but above the serum antibacterial concentration cur ve. Further research should determine whether or not these concepts ha ve important applications in an intracellular environment. Intracellul ar pathogens have been increasingly contributing to respiratory infect ions in the community. Therefore, on the basis of intracellular activi ty against bacteria causing respiratory infections, macrolides are fav oured as the most broad spectrum class of oral antibacterial agents av ailable for the treatment of patients with community-acquired respirat ory infections.