Both drugs are primarily metabolised by the CYP3A4 pathway and are highly bound to plasma proteins (Clarke and Rivory, 1999; Tortorici et al, 2011).
Organophosphates, including CPF, are highly bound to albumin, thereby lowering the bioeffective CPF concentration both in vivo and in culture (Braeckman et al. 1983; Qiao et al. 2001).
Considering that oxa- and cloxacillin are highly bound to albumin (up to 90%) [24], we assumed that the unbound fraction increased in hypoproteinemic patients.
Considering that oxa- and cloxacillin are highly bound to albumin and that their unbound fraction i.e. the available fraction for antibiotic efficacy in healthy patients is known to be 10%, we defined a target range of total antibiotic concentration of 20 50 mg/L to reach the 100% T > MIC.
We focus on drugs that are highly bound as this will restrict their potential to move freely into the skin but which are lipophilic so that, in the unbound form, they would demonstrate an affinity to the outer layers of the skin.
Ritonavir but also lopinavir are highly bound in plasma to albumin and α1-acid glycoprotein [32].
With the exception of indinavir [ 27], all other PIs, including saquinavir and nelfinavir, are highly bound to albumin and α-1 acid glycoprotein in plasma.
These results may reflect the fact that benzodiazepines are highly bound to proteins; their neutral or weak acidic properties further decrease diffusion into VH, which may be alkaline, as observed in postmortem samples, with a mean pH value of 8.3 and range of 7.3 9.1 [ 267].
All are highly bound to plasma protein, do not diffuse through the blood brain barrier and/or the blood-ocular barrier, have a low propensity for drug-drug pharmacokinetic interaction (especially anidulafungin), are not renally cleared and have elimination half-lives long enough to allow once-daily administration.
