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Foundations of Antibiotic Pharmacokinetics
1944 - 1950
During this period, foundational pharmacokinetic principles for antibiotics were established by correlating penicillin blood levels with therapeutic outcomes and by exploring retention strategies that shaped early dosing paradigms. Investigations into tissue distribution revealed penicillin penetration into ocular tissues, while the formalized examination of systemic pharmacokinetics for streptomycin highlighted how absorption, distribution, and excretion govern efficacy across species. Together, these studies clarified the relationships among serum concentrations, tissue exposure, and therapeutic potential, refining approaches to dosing and administration. Historical Significance: Speculations on the Therapeutic Significance of the Penicillin Blood Level introduced the idea that antibiotic efficacy tracks blood concentrations and suggested target levels that would guide dosing, anchoring an emerging pharmacokinetic/pharmacodynamic mindset. Further, tissue-penetration studies, including ocular data, provided concrete pharmacokinetic endpoints that informed dosing for infections at distinct sites. Early methodological advances, such as the development of penicillin assay techniques and in vivo evaluations of antibiotic activity, underscored the role of host factors in shaping antimicrobial therapy.
• Pharmacokinetic optimization through measured penicillin blood levels and retention strategies shaped early dosing paradigms, linking variable penicillin blood levels and serum interactions to therapeutic outcomes [7], [20], [12], [11], [13].
• Eye and ocular tissue penetration investigations reveal how penicillin reaches anterior chamber structures, illustrating tissue-specific distribution as a key determinant of therapeutic success and informing ophthalmologic applications [3], [9], [18].
• Chemical nature and stability of penicillin, including serum-mediated inactivation and comparative activity of penicillin variants, shaped understanding of drug viability, dosing, and comparative therapeutic potential [4], [13], [19].
• Systemic pharmacokinetics of streptomycin in humans and animals, including absorption, distribution, and excretion, established first modern models for antibiotic disposition and informed concurrent antimicrobial pharmacology [14], [17], [8].
Quantitative Antimicrobial Pharmacokinetics
1951 - 1957
Foundations of Antimicrobial Pharmacokinetics
1958 - 1967
Foundations of Pharmacokinetic–Pharmacodynamic Driven Antimicrobial Dosing (1968–1974)
1968 - 1974
Pharmacokinetic Guided Dosing
1975 - 1981
Tissue-Directed Pharmacokinetics and Dosing
1982 - 1988
PK/PD Guided Dosing
1989 - 1995
Unified AUC/MIC PK/PD
1996 - 2002
Pharmacokinetic-Pharmacodynamic Optimization
2003 - 2009
Pharmacokinetic-Driven Antimicrobial Optimization
2010 - 2016
Bayesian Model-Based Dosing
2017 - 2023