Defining antibiotic dosing in lung infections

Defining optimal antibiotic dosing for treatment of lung infections is challenging because of the interrelationship between patient characteristics (eg, pathophysiological changes of lung during an infection, albumin level, renal function), antibiotic characteristics (eg, physicochemical properties,...

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Main Authors:	Jamal, Jannatul-Ain, Abdul Aziz, Mohd. Hafiz, Lipman, Jeffrey, Roberts, Jason A.
Format:	Article
Language:	English
Published:	Lippincott Williams & Wilkins 2013
Subjects:	R Medicine (General) RM Therapeutics. Pharmacology RS Pharmacy and materia medica
Online Access:	http://irep.iium.edu.my/30511/ http://irep.iium.edu.my/30511/ http://irep.iium.edu.my/30511/ http://irep.iium.edu.my/30511/1/Ain_2013-1.CPM.pdf

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recordtype	eprints
spelling	iium-305112014-04-08T21:46:02Z http://irep.iium.edu.my/30511/ Defining antibiotic dosing in lung infections Jamal, Jannatul-Ain Abdul Aziz, Mohd. Hafiz Lipman, Jeffrey Roberts, Jason A. R Medicine (General) RM Therapeutics. Pharmacology RS Pharmacy and materia medica Defining optimal antibiotic dosing for treatment of lung infections is challenging because of the interrelationship between patient characteristics (eg, pathophysiological changes of lung during an infection, albumin level, renal function), antibiotic characteristics (eg, physicochemical properties, protein binding), and bacterial pathogen susceptibility. Measurement of antibiotic concentration in the lung compartments, such as epithelial lining fluid (ELF), is important to describe the drug exposure at site of infection. This article reviews published data on antibiotic penetration described by the ELF to plasma (ELF:plasma) ratios and the probability of pharmacokinetic/pharmacodynamics (PK/PD) attainment at the target site with current dosing regimens to outline dosing strategies that could optimize the PK/PD indices. Antibiotic physicochemical properties could be used to predict the extent of penetration into the lung tissues. Lipophilic antibiotics penetrate well into the lung compartments; however, standard dosing regimens generally seem to be insufficient to achieve optimal PK/PD indices in the ELF, particularly during severe infections. Aggressive dosing regimens are required for antibiotics that poorly or moderately penetrate the lung tissues, whereas nebulization could be the alternative method to enhance antibiotic concentration at the target site. Special populations such as the critically ill, patients on renal replacement therapy, and those with renal impairment need dosing to be individualized, as these populations have high PK variability. Dosing based on free drug concentrations should be considered preferred, as these concentrations frequently reflect the antibiotic concentration at the target site. Therefore, the use of therapeutic drug monitoring should be considered necessary, whenever possible, to guide dosing in lung infection. Lippincott Williams & Wilkins 2013-05 Article PeerReviewed application/pdf en http://irep.iium.edu.my/30511/1/Ain_2013-1.CPM.pdf Jamal, Jannatul-Ain and Abdul Aziz, Mohd. Hafiz and Lipman, Jeffrey and Roberts, Jason A. (2013) Defining antibiotic dosing in lung infections. Clinical Pulmonary Medicine, 20 (3). pp. 121-128. ISSN 1536-5956 (O), 1068-0640 (P) http://journals.lww.com/clinpulm/Abstract/2013/05000/Defining_Antibiotic_Dosing_in_Lung_Infections.3.aspx 10.1097/CPM.0b013e31828fc646
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General) RM Therapeutics. Pharmacology RS Pharmacy and materia medica
spellingShingle	R Medicine (General) RM Therapeutics. Pharmacology RS Pharmacy and materia medica Jamal, Jannatul-Ain Abdul Aziz, Mohd. Hafiz Lipman, Jeffrey Roberts, Jason A. Defining antibiotic dosing in lung infections
description	Defining optimal antibiotic dosing for treatment of lung infections is challenging because of the interrelationship between patient characteristics (eg, pathophysiological changes of lung during an infection, albumin level, renal function), antibiotic characteristics (eg, physicochemical properties, protein binding), and bacterial pathogen susceptibility. Measurement of antibiotic concentration in the lung compartments, such as epithelial lining fluid (ELF), is important to describe the drug exposure at site of infection. This article reviews published data on antibiotic penetration described by the ELF to plasma (ELF:plasma) ratios and the probability of pharmacokinetic/pharmacodynamics (PK/PD) attainment at the target site with current dosing regimens to outline dosing strategies that could optimize the PK/PD indices. Antibiotic physicochemical properties could be used to predict the extent of penetration into the lung tissues. Lipophilic antibiotics penetrate well into the lung compartments; however, standard dosing regimens generally seem to be insufficient to achieve optimal PK/PD indices in the ELF, particularly during severe infections. Aggressive dosing regimens are required for antibiotics that poorly or moderately penetrate the lung tissues, whereas nebulization could be the alternative method to enhance antibiotic concentration at the target site. Special populations such as the critically ill, patients on renal replacement therapy, and those with renal impairment need dosing to be individualized, as these populations have high PK variability. Dosing based on free drug concentrations should be considered preferred, as these concentrations frequently reflect the antibiotic concentration at the target site. Therefore, the use of therapeutic drug monitoring should be considered necessary, whenever possible, to guide dosing in lung infection.
format	Article
author	Jamal, Jannatul-Ain Abdul Aziz, Mohd. Hafiz Lipman, Jeffrey Roberts, Jason A.
author_facet	Jamal, Jannatul-Ain Abdul Aziz, Mohd. Hafiz Lipman, Jeffrey Roberts, Jason A.
author_sort	Jamal, Jannatul-Ain
title	Defining antibiotic dosing in lung infections
title_short	Defining antibiotic dosing in lung infections
title_full	Defining antibiotic dosing in lung infections
title_fullStr	Defining antibiotic dosing in lung infections
title_full_unstemmed	Defining antibiotic dosing in lung infections
title_sort	defining antibiotic dosing in lung infections
publisher	Lippincott Williams & Wilkins
publishDate	2013
url	http://irep.iium.edu.my/30511/ http://irep.iium.edu.my/30511/ http://irep.iium.edu.my/30511/ http://irep.iium.edu.my/30511/1/Ain_2013-1.CPM.pdf
first_indexed	2023-09-18T20:44:40Z
last_indexed	2023-09-18T20:44:40Z
_version_	1777409594977419264

Defining antibiotic dosing in lung infections

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