Antibiotic dosing for multidrug-resistant pathogen pneumonia

Abdul-Aziz, Mohd. H., Lipman, Jeffrey and Roberts, Jason A. (2016) Antibiotic dosing for multidrug-resistant pathogen pneumonia. Current Opinion in Infectious Diseases, 30 2: 231-239. doi:10.1097/QCO.0000000000000348


Author Abdul-Aziz, Mohd. H.
Lipman, Jeffrey
Roberts, Jason A.
Title Antibiotic dosing for multidrug-resistant pathogen pneumonia
Journal name Current Opinion in Infectious Diseases   Check publisher's open access policy
ISSN 1473-6527
0951-7375
Publication date 2016-12-24
Year available 2017
Sub-type Article (original research)
DOI 10.1097/QCO.0000000000000348
Open Access Status Not yet assessed
Volume 30
Issue 2
Start page 231
End page 239
Total pages 9
Place of publication London, United Kingdom
Publisher Lippincott Williams & Wilkins
Language eng
Subject 2726 Microbiology (medical)
2725 Infectious Diseases
Abstract Purpose of review Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens. Recent findings Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections. Antibiotic dosing can be guided by plasma drug concentrations, which do not reflect the concentrations at the site of infection. The application of aggressive dosing regimens, in accordance to the antibiotic's pharmacokinetic/pharmacodynamic characteristics, may be required to ensure rapid and effective drug exposure in infected lung tissues. Summary Conventional antibiotic dosing increases the likelihood of therapeutic failure in critically ill patients with nosocomial pneumonia. Alternative dosing strategies, which exploit the pharmacokinetic/ pharmacodynamic properties of an antibiotic, should be strongly considered to ensure optimal antibiotic exposure and better therapeutic outcomes in these patients.
Formatted abstract
Purpose of review: Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens.

Recent findings: Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections. Antibiotic dosing can be guided by plasma drug concentrations, which do not reflect the concentrations at the site of infection. The application of aggressive dosing regimens, in accordance to the antibiotic╩╝s pharmacokinetic/pharmacodynamic characteristics, may be required to ensure rapid and effective drug exposure in infected lung tissues.

Summary: Conventional antibiotic dosing increases the likelihood of therapeutic failure in critically ill patients with nosocomial pneumonia. Alternative dosing strategies, which exploit the pharmacokinetic/pharmacodynamic properties of an antibiotic, should be strongly considered to ensure optimal antibiotic exposure and better therapeutic outcomes in these patients.
Keyword Antibiotics
Dosing
Pharmacodynamics
Pharmacokinetics
Resistance
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID APP1048652
APP1099452
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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