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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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Advances in antibiotic therapy in the critically ill
Jean-Louis Vincent1, Matteo Bassetti2, Bruno François3
1Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, 1070, Brussels, Belgium. jlvincent@intensive.org.
Critical Care (London, England)
|May 18, 2016
Summary
Managing infections in critically ill patients is complex due to resistance and diagnostic challenges. This review covers early diagnosis, antibiotic therapy controversies, and dosing adjustments for critical care patients.
Area of Science:
- Critical care medicine
- Infectious diseases
- Pharmacology
Background:
- Infections are common in critically ill patients, posing significant management challenges.
- Difficulties include delayed diagnosis, pathogen identification, and rising antibiotic resistance.
Purpose of the Study:
- To review key issues in antibiotic management for critically ill patients.
- To discuss early diagnosis, therapeutic strategies, and pharmacokinetics.
Main Methods:
- Literature review focusing on antibiotic use in critical care.
- Discussion of pharmacodynamic and pharmacokinetic alterations in critical illness.
- Consideration of specific patient subgroups and emerging therapies.
Main Results:
- Early diagnosis and appropriate antibiotic selection are crucial.
- Controversies exist regarding combination vs. monotherapy, duration, and de-escalation.
- Altered pharmacokinetics/pharmacodynamics necessitate adjusted dosing regimens.
Conclusions:
- Optimizing antibiotic therapy in critically ill patients requires careful consideration of diagnosis, resistance, pharmacokinetics, and individual patient factors.
- Future antibiotic development holds promise for improved outcomes.
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