From our Chief Medical Director, Professor Scott Glickman:
With people working on AMR from cystitis treatments, I would be grateful to discuss the following conundrum.
My analysis indicates that the oral/systemic route of administration is critically flawed by rate-limited initial drug filtration and ureteric drip-feed of antibiotic into urinary pools of sufficient volumes to delay it reaching MIC, and with its fluctuant pH likely dynamically altering MIC in-vivo as well, thus potentially providing a window of opportunity for bacteria to react in defence before therapeutic threshold is reached, but haven't determined if it can be tested experimentally, because there are too many uncontrollable variables.
Does anybody have any helpful ideas or is modelling the only option?
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