Therapeutic drug monitoring of anti-infective agents in critically ill patients

Jager, Nynke G., van Hest, Reinier M., Lipman, Jeffrey, Taccone, Fabio S. and Roberts, Jason A. (2016) Therapeutic drug monitoring of anti-infective agents in critically ill patients. Expert Review of Clinical Pharmacology, 9 7: 961-979. doi:10.1586/17512433.2016.1172209

Author Jager, Nynke G.
van Hest, Reinier M.
Lipman, Jeffrey
Taccone, Fabio S.
Roberts, Jason A.
Title Therapeutic drug monitoring of anti-infective agents in critically ill patients
Journal name Expert Review of Clinical Pharmacology   Check publisher's open access policy
ISSN 1751-2441
Publication date 2016-04-15
Year available 2016
Sub-type Article (original research)
DOI 10.1586/17512433.2016.1172209
Open Access Status Not Open Access
Volume 9
Issue 7
Start page 961
End page 979
Total pages 19
Place of publication Abingdon, Oxfordshire, United Kingdom
Publisher Taylor & Francis
Collection year 2017
Language eng
Abstract Initial adequate anti-infective therapy is associated with significantly improved clinical outcomes for patients with severe infections. However, in critically ill patients, several pathophysiological and/or iatrogenic factors may affect the pharmacokinetics of anti-infective agents leading to suboptimal drug exposure, in particular during the early phase of therapy. Therapeutic drug monitoring (TDM) may assist to overcome this problem. We discuss the available evidence on the use of TDM in critically ill patient populations for a number of anti-infective agents, including aminoglycosides, β-lactams, glycopeptides, antifungals and antivirals. Also, we present the available evidence on the practices of anti-infective TDM and describe the potential utility of TDM to improve treatment outcome in critically ill patients with severe infections. For aminoglycosides, glycopeptides and voriconazole, beneficial effects of TDM have been established on both drug effectiveness and potential side effects. However, for other drugs, therapeutic ranges need to be further defined to optimize treatment prescription in this setting.
Keyword Anti-infectives
Critically ill
Intensive care
Therapeutic drug monitoring
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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