Clarithromycin: Pharmacokinetic and pharmacodynamic interrelationships anddosage regimen

In the last decade three important pharmacodynamic parameters: T>MIC, C-max /MIC and AUC/MIC, have been shown to correlate well with in-vitro antimicro bial efficacy and that found in animal models, differentiating among groups of antibiotics with diverse mechanisms of action such as exposure time or concentration-dependent effect. The macrolide antimicrobial agents display variable concentration-dependent killing, indicating the increasing importa nce of the C-max parameter, Clarithromycin, whose T>MIC and AUC influence i ts clinical efficacy, is in an intermediate position between its progenitor , erythromycin, and the azalides, This paper reviews pharmacokinetic and Dh armacodynamic characteristics of clarithromycin, examining the potential im pact of these properties on the dose and the optimal interval between admin istrations.