Pharmacology of antimicrobials used in the treatment of serious Gram-positive bacteria infections
García Quetglas E, Azanza Perea JR, Sádaba Diaz de Rada B, Gil Aldea I.
Servicio de Farmacología Clínica, Clínica Universitaria de Navarra, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
Antimicrobials with specific activity against Gram-positive cocci (glycopeptides, oxazolidinones and streptogramins) have pharmacokinetic differences that are important to know. Linezolid and teicoplanin can be administered extravascularly due to their good bioavailability, allowing their use as sequential therapy in patients requiring prolonged treatment. All of these antimicrobials have an adequate distribution in extracellular tissues, even teicoplanin, due to the balance between the fraction that is bound and unbound to plasma proteins and its long terminal half-life. As the elimination of glycopeptides is almost exclusively renal, it is necessary to perform a posology adjustment in patients with renal failure.
Quinupristin/dalfopristin and linezolid are metabolized by the liver, but CYP450 is only involved in streptogramin elimination.
CITATION Rev Esp Quimioter. 2003 Sep;16(3):277-88