| Summary: | 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
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