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Updated: Apr 3, 2026
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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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Optimizing dosing of antibiotics in critically ill patients
Suzanne L Parker1, Fekade B Sime, Jason A Roberts
1aBurns, Trauma and Critical Care Research Centre, The University of Queensland bDepartment of Intensive Care Medicine cDepartment of Pharmacy, Royal Brisbane Hospital, Brisbane, Australia.
Current Opinion in Infectious Diseases
|September 19, 2015
Summary
Optimizing antibiotic dosing for critically ill patients is crucial due to pharmacokinetic variability. Individualized dosing using therapeutic drug monitoring (TDM) shows promise for improving patient outcomes.
Area of Science:
- Pharmacology
- Critical Care Medicine
- Infectious Diseases
Background:
- Contemporary antibiotic dosing in critically ill patients often fails to achieve optimal outcomes.
- Extensive pharmacokinetic variability and altered pharmacodynamics contribute to unpredictable dose-exposure relationships.
Purpose of the Study:
- To review recent developments in optimizing antibiotic dosing for critically ill patients.
- To highlight the challenges and strategies for individualizing antibiotic therapy.
Main Methods:
- Review of recent studies on antibiotic pharmacokinetics and pharmacodynamics in critically ill populations.
- Discussion of therapeutic drug monitoring (TDM) and emerging dosing software.
Main Results:
- Conventional antibiotic doses frequently lead to sub or supratherapeutic exposures in critically ill patients.
- Pharmacokinetic/pharmacodynamic-based dose optimization can improve antibiotic exposure.
- Therapeutic drug monitoring (TDM) with adaptive feedback is a robust approach for individualizing antibiotic dosing.
Conclusions:
- The role of TDM is expanding beyond toxicity prevention to optimizing antibiotic exposure and patient outcomes.
- Limited evidence currently links TDM practice directly to improved clinical outcomes.
- Further well-designed, multicenter randomized controlled studies are needed to validate TDM's clinical impact.
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