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JAC Advance Access originally published online on December 6, 2007
Journal of Antimicrobial Chemotherapy 2008 61(2):235-237; doi:10.1093/jac/dkm476
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading articles

Tissue concentrations: do we ever learn?

Johan W. Mouton1,*, Ursula Theuretzbacher2, William A. Craig3, Paul M. Tulkens4, Hartmut Derendorf5 and Otto Cars6

1 Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands 2 Center for Anti-Infective Agents, Vienna, Austria 3 Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA 4 Cellular and Molecular Pharmacology Unit, Université catholique de Louvain, Brussels, Belgium 5 Department of Pharmaceutics, University of Florida, Gainesville, FL, USA 6 Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden

* Corresponding author. Tel: +31-24-3657514; Fax: +31-24-3657516; E-mail: mouton{at}cwz.nl

Over the last decades, numerous papers have appeared—and still are appearing—that describe concentrations in tissues in an effort to predict the efficacy of an antimicrobial agent based on these concentrations and MICs for microorganisms. A common method is to use measurements of concentrations in tissue homogenates, comparing these with values derived from the corresponding blood samples and on that basis draw conclusions with respect to the potential clinical use of the drug. This approach is not justifiable for a number of reasons that includes both pharmacokinetic as well as pharmacodynamic causes. This way of presenting data with the derived conclusions is often misleading and may ultimately be harmful in patient care.

Keywords: homogenizing , tissue distribution , pharmacodynamics , pharmacokinetics


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