Fluoroquinolone pharmacodynamics: prospective determination of relationships between exposure and outcome.

By using mathematical modeling it is possible to determine relationships between drug exposure and clinical or microbiological outcome. From the early exploration of Pseudomonas aeruginosa sepsis in neutropenic rats to the prospective determination of relationships between fluoroquinolone exposure and patient outcome in multicenter clinical trials, the utility of this approach has been confirmed. This prospective development of drug concentration-effect relationships can serve as a template for other anti-infective agents. Such relationships will allow rational drug therapy, which may result in maximally efficacious and minimally toxic clinical outcomes for patients and may allow design of regimens to minimize the emergence of drug-resistant pathogens.