Using PK/PD to Optimize Antibiotic Dosing for Critically Ill Patients

Roberts, Jason A. (2011) Using PK/PD to Optimize Antibiotic Dosing for Critically Ill Patients. Current Pharmaceutical Biotechnology, 12 12: 2070-2079. doi:10.2174/138920111798808329

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Author Roberts, Jason A.
Title Using PK/PD to Optimize Antibiotic Dosing for Critically Ill Patients
Journal name Current Pharmaceutical Biotechnology   Check publisher's open access policy
ISSN 1389-2010
Publication date 2011-12-01
Sub-type Article (original research)
DOI 10.2174/138920111798808329
Volume 12
Issue 12
Start page 2070
End page 2079
Total pages 10
Place of publication Bussum, The Netherlands
Publisher Bentham Science Publishers
Collection year 2012
Language eng
Formatted abstract
Antibiotic prescription for critically ill patients is a complicated process because of the pharmacokinetic differences of this patient population with non-critically ill patients and the lack of robust informative studies. This article seeks to review the available literature describing dosing requirements for optimized treatment of critically ill patients and to discuss a framework to rationally address complex cases by outlining the suggested processes for optimal achievement of pharmacokinetic/ pharmacodynamic targets. A variety of papers exist describing the effect of pathophysiology on antibiotic kinetics. In the critically ill patient, dysfunction of almost any organ system can result in significant changes to drug volume of distribution and clearance. Dysfunction of the cardiovascular and renal systems in particular is problematic and can lead to potentially sub-therapeutic antibiotic concentrations in blood and in interstitial fluid. In response to altered pharmacokinetics, dose regimens that adhere to the pharmacodynamics of the antibiotic are essential. In the absence of validated dosing algorithms, therapeutic drug monitoring data and susceptibility data of the infecting pathogen should be inputted into a Bayesian software program that include population pharmacokinetic models to calculate dosing regimens that are personalized for the critically ill patient.
Keyword Pharmacokinetics
Volume Of Distribution
Renal failure
Renal Replacement 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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Citation counts: TR Web of Science Citation Count  Cited 21 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 29 times in Scopus Article | Citations
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Created: Tue, 06 Mar 2012, 18:59:13 EST by System User on behalf of Anaesthesiology and Critical Care - RBWH