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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
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Applying pharmacokinetic/pharmacodynamic principles in critically ill patients: optimizing efficacy and reducing
Mohd H Abdul-Aziz1, Jeffrey Lipman1, Johan W Mouton2
1Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
Seminars in Respiratory and Critical Care Medicine
|February 3, 2015
Summary
Optimizing antibiotic dosing using pharmacokinetic/pharmacodynamic (PK/PD) principles in intensive care units (ICUs) can improve patient outcomes and suppress the emergence of multidrug-resistant pathogens. This approach aims to maximize therapeutic success while preserving antibiotic effectiveness.
Area of Science:
- Infectious Diseases
- Clinical Pharmacology
- Critical Care Medicine
Background:
- Rising rates of multidrug-resistant pathogens and a declining antibiotic development pipeline necessitate optimizing existing antibiotic use.
- Intensive care unit (ICU) patients are particularly vulnerable to infections and antibiotic resistance.
- Pharmacokinetic/pharmacodynamic (PK/PD) target attainment is linked to better clinical and microbiological outcomes in critically ill patients.
Purpose of the Study:
- To review the role of PK/PD characteristics of various antibiotic classes in the development of antibiotic resistance.
- To propose evidence-based dosing recommendations for clinical practice in ICUs.
- To balance maximizing therapeutic success with minimizing the emergence of antibiotic resistance.
Main Methods:
- Literature review focusing on PK/PD principles and antibiotic resistance.
- Analysis of in vitro and in vivo study data.
- Synthesis of available data to formulate clinical dosing recommendations.
Main Results:
- PK/PD principles are crucial for optimizing antibiotic therapy in critically ill patients.
- Antibiotic dosing regimens adhering to PK/PD targets can suppress resistance development.
- Specific PK/PD characteristics influence the emergence of resistance across different antibiotic classes.
Conclusions:
- Optimized antibiotic dosing based on PK/PD targets is essential for both clinical success and resistance suppression in ICUs.
- Clinical adoption of proposed dosing recommendations can enhance therapeutic outcomes and prolong the utility of existing antibiotics.
- A PK/PD-guided approach is vital for combating antibiotic resistance in critical care settings.
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