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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Chronobiology and chronotoxicology of antibiotics and aminoglycosides

Denis Beauchamp1, Gaston Labrecque

  • 1Research Center on Infectious Diseases and Centre Hospitalier Universitaire de Québec, Pavilion CHUL, Canada.

Advanced Drug Delivery Reviews
|July 31, 2007
PubMed

Insights

Circadian rhythms influence infectious disease symptoms and drug effectiveness. Optimizing antimicrobial dosing times, like with aminoglycosides, can reduce toxicity, particularly kidney damage.

Area of Science:

  • Chronobiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Circadian variations in infectious disease symptom intensity are under-researched.
  • Seasonal patterns are known, but daily (circadian) patterns in symptom expression are less appreciated.
  • Fever from infections shows diurnal variation, differing between bacterial and viral causes.

Purpose of the Study:

  • To explore circadian variations in infectious disease symptom intensity.
  • To investigate time-dependent differences in antimicrobial pharmacokinetics and toxicity.
  • To inform the development of less toxic, time-optimized drug formulations.

Main Methods:

  • Review of existing studies on circadian rhythms in infectious diseases.
  • Analysis of diurnal patterns in fever associated with infections.
  • Examination of administration-time-dependent effects of antimicrobial agents, focusing on aminoglycosides.

Main Results:

  • Fever peaks in the afternoon for common colds.
  • Bacterial infection fevers are higher in the evening; viral infection fevers are higher in the morning.
  • Aminoglycoside nephrotoxicity is greatest when administered during the body's resting period.

Conclusions:

  • Circadian rhythms significantly impact infectious disease symptom presentation.
  • Timing of aminoglycoside administration influences nephrotoxicity.
  • Understanding these chronobiological mechanisms can lead to safer, once-daily dosing strategies for antimicrobials.

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