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Protein Binding: Do We Ever Learn?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
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2011 (English)In: Antimicrobial Agents and Chemotherapy, ISSN 0066-4804, E-ISSN 1098-6596, Vol. 55, no 7, 3067-3074 p.Article, review/survey (Refereed) Published
Abstract [en]

Although the influence of protein binding (PB) on antibacterial activity has been reported for many antibiotics and over many years, there is currently no standardization for pharmacodynamic models that account for the impact of protein binding of antimicrobial agents in vitro. This might explain the somewhat contradictory results obtained from different studies. Simple in vitro models which compare the MIC obtained in protein-free standard medium versus a protein-rich medium are prone to methodological pitfalls and may lead to flawed conclusions. Within in vitro test systems, a range of test conditions, including source of protein, concentration of the tested antibiotic, temperature, pH, electrolytes, and supplements may influence the impact of protein binding. As new antibiotics with a high degree of protein binding are in clinical development, attention and action directed toward the optimization and standardization of testing the impact of protein binding on the activity of antibiotics in vitro become even more urgent. In addition, the quantitative relationship between the effects of protein binding in vitro and in vivo needs to be established, since the physiological conditions differ. General recommendations for testing the impact of protein binding in vitro are suggested.

Place, publisher, year, edition, pages
2011. Vol. 55, no 7, 3067-3074 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-156025DOI: 10.1128/AAC.01433-10ISI: 000291687900001OAI: oai:DiVA.org:uu-156025DiVA: diva2:429855
Available from: 2011-07-06 Created: 2011-07-06 Last updated: 2011-07-06Bibliographically approved

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