Why pharmacoeconomics are relevant in managing respiratory infections: How an antibiotic's AUIC can predict outcomes and costs

In the treatment of lower respiratory tract infections, there is a clear association between adverse clinical outcomes and higher costs of care. In patients with acute exacerbations of chronic bronchitis (AECB), the use of antibiotics that eradicate the pathogen quickly is the key to producing good long-term clinical outcomes and reduced overall health care costs. An important pharmacokinetic value that predicts microbial response is the area under the inhibitory concentration curve (AUIC), which essentially defines antibiotic regimens as a ratio of drug exposure to the infecting pathogen's minimum inhibitory concentration to that drug. AUICs can be used to compare the activity of antibiotics-the higher the value, the better the activity. Although the breakpoints are still debated, AUIC values greater than 250 appear to be optimal for rapid killing. Data from the Gemifloxacin Long-Term Outcomes in Bronchitis Exacerbations (GLOBE) study of patients with AECB support the clinical and financial benefits of using antibiotics with high A UICs.