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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antibiotic Considerations in the Critically Ill: Empiric Choices and Dosing
Eric M Gillett1, Kevin M Dube2, Chanu Rhee3
1Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA; Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
None:
Treating infections in critically ill patients is uniquely challenging because of diverse disease states, high rates of antimicrobial resistance, pharmacokinetic changes, and a high risk of mortality that leaves little margin for error. Optimal management requires balancing early, appropriate antimicrobial therapy with risks of toxicity and resistance. To do so, clinicians must integrate microbiologic diagnostics, pathogen epidemiology, patient-specific risk factors, and local resistance rates with an understanding of antimicrobial agents' spectrum and pharmacologic properties and patients' altered pharmacokinetics and pharmacodynamics.
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