Pharmacokinetics of beta-lactam antibiotics in patients with intra-abdominal pathologies: A structured review

Adnan, Syamhanin, Paterson, David, Lipman, Jeffrey, Kumar, Suresh, Li, Janice, Rudd, Michael J and Roberts, Jason (2012) Pharmacokinetics of beta-lactam antibiotics in patients with intra-abdominal pathologies: A structured review. Surgical Infections, 13 1: 9-17. doi:10.1089/sur.2011.046


Author Adnan, Syamhanin
Paterson, David
Lipman, Jeffrey
Kumar, Suresh
Li, Janice
Rudd, Michael J
Roberts, Jason
Title Pharmacokinetics of beta-lactam antibiotics in patients with intra-abdominal pathologies: A structured review
Journal name Surgical Infections   Check publisher's open access policy
ISSN 1096-2964
1557-8674
Publication date 2012-03-05
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1089/sur.2011.046
Volume 13
Issue 1
Start page 9
End page 17
Total pages 9
Place of publication New Rochelle, NY, United States
Publisher Mary Ann Liebert
Collection year 2013
Language eng
Formatted abstract
Background and Purpose: The objective of this structured review was to analyze critically the findings of pharmacokinetic studies of beta-lactam antibiotics in patients with intra-abdominal disease; that is, intra-abdominal infection (IAI) or previous abdominal surgery and determine the requirements for dosage modification in this population.

Methods:
Data were identified by structured review of PUBMED from February 1983 to February 2011. All 14 articles reviewed described the pharmacokinetics of beta-lactam antibiotics in patients with intra-abdominal disease.

Results:
Antibiotic classes included carbapenems, penicillins, cephalosporins, and monobactams. Possible physiological changes in these patients include development of abscesses, perforation, or ischemia of the bowel as well as intra-abdominal hypertension. These disorders may cause changes in antibiotic pharmacokinetics, including increased volume of distribution and faster drug clearance, both resulting in lower antibiotic concentrations. High inter-individual pharmacokinetic variability was common to each of the studies.

Conclusion: Most of the available data demonstrate that drug volume of distribution can be increased significantly in the presence of intra-abdominal disease. Drug clearance is likely to vary in line with renal or hepatic function. Thus, dose optimization is important to prevent development of antibiotic resistance or therapeutic failure. However, further research is necessary to determine the clinical outcome of individualized dosing on the basis of pharmacokinetic/pharmacodynamic studies.
Keyword Abdominal-surgery patients
Critically-ill patients
Intensive-care-unit
Augmented renal clearance
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: UQ Centre for Clinical Research Publications
Official 2013 Collection
School of Medicine Publications
School of Pharmacy Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 9 times in Scopus Article | Citations
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Created: Fri, 23 Dec 2011, 12:47:55 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH