Personalized antimicrobial therapy in critical and elderly patients

Area of Science:

• Pharmacology
• Infectious Diseases
• Critical Care Medicine

Background:

• Personalized therapy is essential for optimizing antimicrobial drug levels to combat infections.
• Understanding drug activity and employing alternative administration routes, such as inhalation, are key to managing new antimicrobials.
• Pharmacokinetic models aid in tailoring antimicrobial treatments, crucial due to the limited activity of novel agents.

Purpose of the Study:

• To review literature on personalized antimicrobial therapy, focusing on optimizing drug levels and administration routes.
• To explore the role of pharmacokinetic models and alternative administration routes in managing infections.
• To address challenges in antimicrobial treatment for geriatric and critical care populations.

Main Methods:

• A non-systematic literature review was conducted.
• A search for high-quality research articles on antimicrobial therapy was performed.
• A selection process involving clinical pharmacists and an intensivist identified 153 relevant articles from an initial 370.

Main Results:

• Geriatric and critical care patients require close antimicrobial monitoring.
• Inhaled administration can lead to high plasma concentrations, particularly in respiratory infections.
• Pharmacokinetic models are valuable for treating geriatric patients, who are often excluded from clinical trials.

Conclusions:

• Personalized antimicrobial therapy is vital for optimizing drug levels, reducing resistance, and enhancing safety.
• Pharmacokinetic modeling and alternative administration routes are essential for effective antimicrobial treatment.
• Special consideration and monitoring are necessary for geriatric and critical care patients receiving antimicrobials.