Antimicrobial Pharmacokinetic and Pharmacodynamic Issues in the Critically Ill with Severe Sepsis and Septic Shock

Varghese, Julie M., Roberts, Jason A. and Lipman, Jeffrey (2011) Antimicrobial Pharmacokinetic and Pharmacodynamic Issues in the Critically Ill with Severe Sepsis and Septic Shock. Critical Care Clinics, 27 1: 19-34. doi:10.1016/j.ccc.2010.09.006


Author Varghese, Julie M.
Roberts, Jason A.
Lipman, Jeffrey
Title Antimicrobial Pharmacokinetic and Pharmacodynamic Issues in the Critically Ill with Severe Sepsis and Septic Shock
Journal name Critical Care Clinics   Check publisher's open access policy
ISSN 0749-0704
Publication date 2011-01-01
Year available 2011
Sub-type Article (original research)
DOI 10.1016/j.ccc.2010.09.006
Open Access Status Not yet assessed
Volume 27
Issue 1
Start page 19
End page 34
Total pages 16
Place of publication Maryland Heights, MO, U.S.A.
Publisher W.B. Saunders Co.
Language eng
Subject 2706 Critical Care and Intensive Care Medicine
Abstract Antimicrobial pharmacokinetics (PK) and pharmacodynamics (PD) are important considerations, particularly in critically ill patients with severe sepsis and septic shock. The pathophysiologic changes that occur in these conditions can have a major effect on pharmacokinetic parameters, which in turn could result in failure to achieve pharmacodynamic targets for antimicrobials thus adversely affecting clinical outcome. This paper discusses the pathophysiologic changes that occur during severe sepsis and septic shock and the consequent effects on antimicrobial PK and PD. The effect of PK/PD on specific antimicrobial classes is discussed and a rational framework for antimicrobial dosing is provided. Knowledge of PK/PD properties of antimicrobials can be used to personalize dosing regimens not only to maximize antimicrobial activity but also to minimize toxicity and reduce the development of antimicrobial resistance.
Keyword Pharmacokinetics
Pharmacodynamics
Volume of distribution
Clearance
Renal failure
Renal replacement therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 519702
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Thu, 22 Sep 2011, 22:05:51 EST by Matthew Lamb on behalf of School of Medicine