Identifying “at-risk” patients for sub-optimal beta-lactam exposure in critically ill patients with severe infections
Pathophysiological changes affecting drug pharmacokinetics Mortality due to severe infections in the intensive care unit (ICU) remains high despite recent therapeutic advancements [1]. However, appropriate antibiotic administration (including spectrum of activity and therapeutic exposure) is r...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English English |
| Published: |
BioMed Central
2017
|
| Subjects: | |
| Online Access: | http://irep.iium.edu.my/59680/ http://irep.iium.edu.my/59680/ http://irep.iium.edu.my/59680/ http://irep.iium.edu.my/59680/1/s13054-017-1871-2.pdf http://irep.iium.edu.my/59680/7/Identifying%20%27at-risk%27%20patients%20for%20sub-optimal%20beta-lactam%20exposure%20in%20critically%20ill%20patients%20with%20severe%20infections.pdf |
| Summary: | Pathophysiological changes affecting drug
pharmacokinetics
Mortality due to severe infections in the intensive care
unit (ICU) remains high despite recent therapeutic
advancements [1]. However, appropriate antibiotic administration
(including spectrum of activity and therapeutic
exposure) is rarely a straightforward process in ICU
patients as they commonly develop extreme pathophysiological
changes that can alter antibiotic pharmacokinetics
and consequently affect drug exposure in this population.
The volume of distribution and drug clearance are the
pharmacokinetic parameters of greatest relevance to determining
drug dosing requirements, and both parameters
may be significantly deranged during critical illness [2, 3].
Furthermore, ICU pathogens are relatively different from
those in the general wards as they commonly have
reduced antibiotic susceptibility [4]. Despite profound
physiological and pharmacokinetic differences to the noncritically
ill population, critically ill patients are typically
given conventional antibiotic dosing regimens, which increase
the likelihood of therapeutic failures and the emergence
of bacterial resistance [5]. |
|---|