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Title: Pharmacokinetic/pharmacodynamic considerations for the optimization of antimicrobial delivery in the critically ill.
Authors: Tsai, Danny
Lipman, Jeffrey
Roberts, Jason A
Citation: Current opinion in critical care 2015-10; 21(5): 412-20
Abstract: Antimicrobials are very commonly used drugs in the intensive care setting. Extensive research has been conducted in recent years to describe their pharmacokinetics/pharmacodynamics in order to maximize the pharmacological benefit and patient outcome. Translating these new findings into clinical practice is encouraged. This article will discuss mechanistic data on factors causing changes in antimicrobial pharmacokinetics in critically ill patients, such as the phenomena of augmented renal clearance as well as the effects of hypoalbuminemia, renal replacement therapy, and extracorporeal membrane oxygenation. Failure to achieve clinical cure has been correlated with pharmacokinetics/pharmacodynamics target nonattainment, and a recent meta-analysis suggests an association between dosing strategies aimed at optimizing antimicrobial pharmacokinetics/pharmacodynamics with improvement in clinical cure and survival. Novel dosing strategies including therapeutic drug monitoring are also now being tested to address challenges in the optimization of antimicrobial pharmacokinetics/pharmacodynamics. Optimization of antimicrobial dosing in accordance with pharmacokinetics/pharmacodynamics targets can improve survival and clinical cure. Dosing regimens for critically ill patients should aim for pharmacokinetics/pharmacodynamics target attainment by utilizing altered dosing strategies including adaptive feedback using therapeutic drug monitoring.
Click to open PubMed article: https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/26348420
Click to open Pubmed Article: https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/26348420
Journal title: Current opinion in critical care
Publication Date: 2015-10
Type: Journal Article
Research Support, Non-U.S. Gov't
Review
URI: https://hdl.handle.net/10137/5444
DOI: 10.1097/MCC.0000000000000229
Appears in Collections:(a) NT Health Research Collection

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