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Erschienen in:

07.05.2020 | Conference Report and Expert Panel

Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper_#

verfasst von: Mohd H. Abdul-Aziz, Jan-Willem C. Alffenaar, Matteo Bassetti, Hendrik Bracht, George Dimopoulos, Deborah Marriott, Michael N. Neely, Jose-Artur Paiva, Federico Pea, Fredrik Sjovall, Jean F. Timsit, Andrew A. Udy, Sebastian G. Wicha, Markus Zeitlinger, Jan J. De Waele, Jason A. Roberts, the Infection Section of European Society of Intensive Care Medicine (ESICM), Pharmacokinetic/pharmacodynamic and Critically Ill Patient Study Groups of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Group of International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT), Infections in the ICU and Sepsis Working Group of International Society of Antimicrobial Chemotherapy (ISAC)

Erschienen in: Intensive Care Medicine | Ausgabe 6/2020

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Abstract

Purpose

This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in critically ill adult patients in the intensive care unit (ICU). This Position Paper also provides a practical guide on how TDM can be applied in routine clinical practice to improve therapeutic outcomes in critically ill adult patients.

Methods

Literature review and analysis were performed by Panel Members nominated by the endorsing organisations, European Society of Intensive Care Medicine (ESICM), Pharmacokinetic/Pharmacodynamic and Critically Ill Patient Study Groups of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), International Association for Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT) and International Society of Antimicrobial Chemotherapy (ISAC). Panel members made recommendations for whether TDM should be applied clinically for different antimicrobials/classes.

Results

TDM-guided dosing has been shown to be clinically beneficial for aminoglycosides, voriconazole and ribavirin. For most common antibiotics and antifungals in the ICU, a clear therapeutic range has been established, and for these agents, routine TDM in critically ill patients appears meritorious. For the antivirals, research is needed to identify therapeutic targets and determine whether antiviral TDM is indeed meritorious in this patient population. The Panel Members recommend routine TDM to be performed for aminoglycosides, beta-lactam antibiotics, linezolid, teicoplanin, vancomycin and voriconazole in critically ill patients.

Conclusion

Although TDM should be the standard of care for most antimicrobials in every ICU, important barriers need to be addressed before routine TDM can be widely employed worldwide.

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Titel: Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper#
verfasst von: Mohd H. Abdul-Aziz
Jan-Willem C. Alffenaar
Matteo Bassetti
Hendrik Bracht
George Dimopoulos
Deborah Marriott
Michael N. Neely
Jose-Artur Paiva
Federico Pea
Fredrik Sjovall
Jean F. Timsit
Andrew A. Udy
Sebastian G. Wicha
Markus Zeitlinger
Jan J. De Waele
Jason A. Roberts
the Infection Section of European Society of Intensive Care Medicine (ESICM)
Pharmacokinetic/pharmacodynamic and Critically Ill Patient Study Groups of European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
Infectious Diseases Group of International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT)
Infections in the ICU and Sepsis Working Group of International Society of Antimicrobial Chemotherapy (ISAC)
Publikationsdatum: 07.05.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 6/2020
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-020-06050-1

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Springer Medizin

Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper_#

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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