Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria
Critically ill patients suffering from severe infections are prone to pathophysiological pharmacokinetic changes that are frequently associated with inadequate antibiotic serum concentrations. Minimum inhibitory concentrations (MICs) of the causative pathogens tend to be higher in intensive care uni...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/12/3/475 |
| _version_ | 1797613828644536320 |
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| author | Jesus Ruiz-Ramos Laura Gras-Martín Paula Ramírez |
| author_facet | Jesus Ruiz-Ramos Laura Gras-Martín Paula Ramírez |
| author_sort | Jesus Ruiz-Ramos |
| collection | DOAJ |
| description | Critically ill patients suffering from severe infections are prone to pathophysiological pharmacokinetic changes that are frequently associated with inadequate antibiotic serum concentrations. Minimum inhibitory concentrations (MICs) of the causative pathogens tend to be higher in intensive care units. Both pharmacokinetic changes and high antibiotic resistance likely jeopardize the efficacy of treatment. The use of extracorporeal circulation devices to support hemodynamic, respiratory, or renal failure enables pharmacokinetic changes and makes it even more difficult to achieve an adequate antibiotic dose. Besides a clinical response, antibiotic pharmacokinetic optimization is important to reduce the selection of strains resistant to common antibiotics. In this review, we summarize the present knowledge regarding pharmacokinetic changes in critically ill patients and we discuss the effects of extra-corporeal devices on antibiotic treatment together with potential solutions. |
| first_indexed | 2024-03-11T07:01:10Z |
| format | Article |
| id | doaj.art-115a738293af4822aaab37670d6da92e |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T07:01:10Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-115a738293af4822aaab37670d6da92e2023-11-17T09:13:30ZengMDPI AGAntibiotics2079-63822023-02-0112347510.3390/antibiotics12030475Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant BacteriaJesus Ruiz-Ramos0Laura Gras-Martín1Paula Ramírez2Pharmacy Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, SpainPharmacy Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, SpainIntensive Care Unit, Hospital Universitario y Politécnico La Fe, 46026 Valencia, SpainCritically ill patients suffering from severe infections are prone to pathophysiological pharmacokinetic changes that are frequently associated with inadequate antibiotic serum concentrations. Minimum inhibitory concentrations (MICs) of the causative pathogens tend to be higher in intensive care units. Both pharmacokinetic changes and high antibiotic resistance likely jeopardize the efficacy of treatment. The use of extracorporeal circulation devices to support hemodynamic, respiratory, or renal failure enables pharmacokinetic changes and makes it even more difficult to achieve an adequate antibiotic dose. Besides a clinical response, antibiotic pharmacokinetic optimization is important to reduce the selection of strains resistant to common antibiotics. In this review, we summarize the present knowledge regarding pharmacokinetic changes in critically ill patients and we discuss the effects of extra-corporeal devices on antibiotic treatment together with potential solutions.https://www.mdpi.com/2079-6382/12/3/475pharmacokineticsantibiotic resistanceantibiotic activityintensive care unitmultidrug-resistant pathogens |
| spellingShingle | Jesus Ruiz-Ramos Laura Gras-Martín Paula Ramírez Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria Antibiotics pharmacokinetics antibiotic resistance antibiotic activity intensive care unit multidrug-resistant pathogens |
| title | Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria |
| title_full | Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria |
| title_fullStr | Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria |
| title_full_unstemmed | Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria |
| title_short | Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria |
| title_sort | antimicrobial pharmacokinetics and pharmacodynamics in critical care adjusting the dose in extracorporeal circulation and to prevent the genesis of multiresistant bacteria |
| topic | pharmacokinetics antibiotic resistance antibiotic activity intensive care unit multidrug-resistant pathogens |
| url | https://www.mdpi.com/2079-6382/12/3/475 |
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