Re: why ceftriaxone (vs other B-lactams)?

[Guest guest]

I know two another factors that makes this a physician/patient " favorite " are

(A) the

once daily dosing and ( not too hard on the veins so peripheral access can be

used

if necessary.

> If anyone can add something, be it data or further aspects of

> consideration, heres the analysis of B-lactam therapy I'm starting on.

>

> FACTORS:

>

> - brain penetration... v important

>

> - host cell penetration... may be critical

>

> - organism penetration/lethality

>

> [above 3 factors probably depend largely on

> hydrophobicitiy/hydrophilicity of various drugs at physiologic pH,

> but theres probably good empirical data to use, so here theoretics

> are just to organize ones knowledge]

>

> - expense... are the older drugs much cheaper? if so perhaps one

> could obtain a longer-term IV treatment using them. Longer is better.

>

> - half-life in serum and brain... longer the better

>

> - recalcitrance of drug to organisms' B-lactamases (not important for

> Bb as far as I know)

>

> - toxicity... bah who cares (just kidding). Maximum safe/affordable

> dose may be important as L-forms may become sensitive (if at all)

> only at a higher concentration.

>

> - where data are available, a good consideration is

> activity/inactivity within host cells due to causes mysterious (there

> are examples where such inactivity doesnt correspond to any sensible

> explanation)

[Guest guest]

Aha. Do some B-lactams require what they call a " port " ? And does that

cost a few thousand to get put in, as I hear?

Isnt there some way to put caustic drugs thru a PICC, if theyre

dilute and you do it real slow? Or just flat out not do-able?

> > If anyone can add something, be it data or further aspects of

> > consideration, heres the analysis of B-lactam therapy I'm

starting on.

> >

> > FACTORS:

> >

> > - brain penetration... v important

> >

> > - host cell penetration... may be critical

> >

> > - organism penetration/lethality

> >

> > [above 3 factors probably depend largely on

> > hydrophobicitiy/hydrophilicity of various drugs at physiologic

pH,

> > but theres probably good empirical data to use, so here

theoretics

> > are just to organize ones knowledge]

> >

> > - expense... are the older drugs much cheaper? if so perhaps one

> > could obtain a longer-term IV treatment using them. Longer is

better.

> >

> > - half-life in serum and brain... longer the better

> >

> > - recalcitrance of drug to organisms' B-lactamases (not important

for

> > Bb as far as I know)

> >

> > - toxicity... bah who cares (just kidding). Maximum

safe/affordable

> > dose may be important as L-forms may become sensitive (if at all)

> > only at a higher concentration.

> >

> > - where data are available, a good consideration is

> > activity/inactivity within host cells due to causes mysterious

(there

> > are examples where such inactivity doesnt correspond to any

sensible

> > explanation)