Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria

被引：4

作者：

Ruiz-Ramos, Jesus ^{[1
]}

Gras-Martin, Laura ^{[1
]}

Ramirez, Paula ^{[2
]}

机构：

[1] Hosp Santa Creu & Sant Pau, Pharm Dept, Barcelona 08025, Spain

[2] Hosp Univ & Politecn La Fe, Intens Care Unit, Valencia 46026, Spain

来源：

ANTIBIOTICS-BASEL | 2023年 / 12卷 / 03期

关键词：

pharmacokinetics; antibiotic resistance; antibiotic activity; intensive care unit; multidrug-resistant pathogens; RENAL REPLACEMENT THERAPY; RESISTANT STAPHYLOCOCCUS-AUREUS; ILL PATIENTS; POPULATION PHARMACOKINETICS; MEMBRANE-OXYGENATION; ACINETOBACTER-BAUMANNII; PSEUDOMONAS-AERUGINOSA; SEPTIC SHOCK; MURINE THIGH; BETA-LACTAM;

D O I：

10.3390/antibiotics12030475

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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.

引用

页数：14