beta-Lactam pharmacokinetics and pharmacodynamics in critically ill patients and strategies for dose optimization: A structured review

Sinnollareddy, Mahipal G., Roberts, Michael S., Lipman, Jeffrey and Roberts, Jason A. (2012) beta-Lactam pharmacokinetics and pharmacodynamics in critically ill patients and strategies for dose optimization: A structured review. Clinical and Experimental Pharmacology and Physiology, 39 6: 489-496.


Author Sinnollareddy, Mahipal G.
Roberts, Michael S.
Lipman, Jeffrey
Roberts, Jason A.
Title beta-Lactam pharmacokinetics and pharmacodynamics in critically ill patients and strategies for dose optimization: A structured review
Formatted title β-Lactam pharmacokinetics and pharmacodynamics in critically ill patients and strategies for dose optimization: A structured review
Journal name Clinical and Experimental Pharmacology and Physiology   Check publisher's open access policy
ISSN 0305-1870
1440-1681
Publication date 2012-06
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/j.1440-1681.2012.05715.x
Volume 39
Issue 6
Start page 489
End page 496
Total pages 8
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2013
Language eng
Formatted abstract     1. Infections and related sepsis are two of the most prevalent issues in the care of critically ill patients, with mortality as high as 70%. Appropriate antibiotic selection, as well as adequate dosing, is important to improve the clinical outcome for these patients.
     2. β-Lactams are the most common antibiotic class used in critically ill sepsis patients because of their broad spectrum of activity and high tolerability. β-Lactams exhibit time-dependent antibacterial activity. Therefore, concentrations need to be maintained above the minimum inhibitory concentration (MIC) of pathogenic bacteria. β-Lactams are hydrophilic antibiotics with small distribution volumes similar to extracellular water and are predominantly excreted through the renal system.
     3. Critically ill patients experience a myriad of physiological changes that result in changes in the pharmacokinetics (PK) of hydrophilic drugs such as β-lactams. A different
approach to dosing with β-lactams may increase the likelihood of positive outcomes considering the pharmacodynamics (PD) of β-lactams, as well as the changes in PK in critically ill patients.
     4. The present review describes the strategies for dose optimization of β-lactams in critically ill patients in line with the PK and PD of these drugs.
Keyword β-lactams
Critically ill
Dose optimization
Pharmacodynamics
Pharmacokinetics
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: Official 2013 Collection
School of Medicine Publications
 
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