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Related Experiment Video

Updated: Nov 25, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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[Medication during severe infections].

Jessica D Workum1, Frans T Huysmans, Quirijn de Mast2

  • 1Radboudumc, Nijmegen. Afd. Farmacologie-Toxicologie.

Nederlands Tijdschrift Voor Geneeskunde
|December 17, 2020
PubMed
Summary
This summary is machine-generated.

Severe infections alter drug distribution and renal function, impacting medication effectiveness. Adjusting doses or temporarily stopping renally cleared drugs, especially antibiotics, is crucial to maintain therapeutic levels and patient safety.

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Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Nephrology

Background:

  • Severe infectious diseases significantly alter physiological parameters, including drug distribution and renal function.
  • Understanding these changes is critical for managing patients with acute illnesses and pre-existing conditions.

Observation:

  • Renal function can be paradoxically increased early in severe infections.
  • Drug clearance and volume of distribution are significantly affected, particularly for renally cleared medications.

Findings:

  • Renally cleared drugs with narrow therapeutic indices require dose adjustments or temporary discontinuation to prevent toxicity or subtherapeutic levels.
  • Specific drug classes need tailored management: RAAS inhibitors and diuretics interrupted, beta-blockers continued, NSAIDs contraindicated, and corticosteroids given stress doses.

Implications:

  • Optimized medication management during severe infections improves patient outcomes and reduces adverse events.
  • This guidance aids clinicians in making informed decisions regarding drug therapy in critically ill patients.
  • Further research into pharmacokinetics during severe infections can refine treatment protocols.