The relevance of drug volume of distribution in antibiotic dosing

Ulldemolins, Marta and Rello, Jordi (2011) The relevance of drug volume of distribution in antibiotic dosing. Current Pharmaceutical Biotechnology, 12 12: 1996-2001. doi:10.2174/138920111798808365

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Author Ulldemolins, Marta
Rello, Jordi
Title The relevance of drug volume of distribution in antibiotic dosing
Journal name Current Pharmaceutical Biotechnology   Check publisher's open access policy
ISSN 1389-2010
1873-4316
Publication date 2011-12
Sub-type Article (original research)
DOI 10.2174/138920111798808365
Volume 12
Issue 12
Start page 1996
End page 2001
Total pages 6
Place of publication Bussum, Netherlands
Publisher Bentham Science Publishers
Collection year 2012
Language eng
Abstract Despite the importance of early an appropriate therapy for the outcomes of severe infections in critically ill patients, there is still little understanding of dose optimization during the most important phase of the treatment, the initial phase. Disease-driven variations in pharmacokinetics and pharmacokinetics/ pharmacodynamics may compromise the therapeutic success of antibiotic therapy. Therefore, dose adjustments that account for these variations are paramount for improving antibiotic use in critically ill patients. Compelling evidence shows significant increases in the Vd of both hydrophilic and lipophilic drugs in critically ill patients as a consequence of patient pathology and from clinical interventions. These increases in the Vd can lead to lower than expected plasma concentrations during the first day of therapy, which may result in sub-optimal achievement of antibiotic pharmacokinetics/pharmacodynamic targets, resulting in inappropriate treatment. Therefore, loading doses of antibiotic during the first day of therapy that account for the predicted increase in the Vd are required. Further research towards the establishment of new dosing regimens that use loading doses to satisfy such increased volumes of distribution is recommended.
Keyword Critically ill patient
Pharmacokinetics
Pharmacodynamics
Intensive care unit
Optimal therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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