Skip to main content
Erschienen in: Intensive Care Medicine 5/2019

14.01.2019 | Editorial

Personalized antibiotic dosing for the critically ill

verfasst von: Jason A. Roberts, Claire Roger, Jan J. De Waele

Erschienen in: Intensive Care Medicine | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Excerpt

Therapeutic antibiotic exposures (concentrations) have been demonstrated to improve clinical cure, reduce drug toxicity and even reduce mortality in infected critically ill patients [13]. With persisting high morbidity and mortality associated with sepsis and septic shock in these patients, optimisation of antibiotic exposures is a key treatment intervention. However, there are various patient, diagnostic, treatment and pathology-related factors which complicate this process. A dosing strategy that is personalised to the individual’s needs is required during critical illness to ensure these exposures associated with patient benefit are achieved [4]. …
Literatur
1.
Zurück zum Zitat Tangden T, Ramos Martin V, Felton TW, Nielsen EI, Marchand S, Bruggemann RJ, Bulitta JB, Bassetti M, Theuretzbacher U, Tsuji BT, Wareham DW, Friberg LE, De Waele JJ, Tam VH, Roberts JA, Infection Section for the European Society of Intensive Care Medicine tP, Pharmacodynamics Study Group of the European Society of Clinical M, Infectious Diseases tISoA-IP, the Critically Ill Patients Study Group of European Society of Clinical M, Infectious D (2017) The role of infection models and PK/PD modelling for optimising care of critically ill patients with severe infections. Intensive Care Med 43:1021–1032CrossRefPubMed Tangden T, Ramos Martin V, Felton TW, Nielsen EI, Marchand S, Bruggemann RJ, Bulitta JB, Bassetti M, Theuretzbacher U, Tsuji BT, Wareham DW, Friberg LE, De Waele JJ, Tam VH, Roberts JA, Infection Section for the European Society of Intensive Care Medicine tP, Pharmacodynamics Study Group of the European Society of Clinical M, Infectious Diseases tISoA-IP, the Critically Ill Patients Study Group of European Society of Clinical M, Infectious D (2017) The role of infection models and PK/PD modelling for optimising care of critically ill patients with severe infections. Intensive Care Med 43:1021–1032CrossRefPubMed
2.
Zurück zum Zitat Roberts JA, Paul SK, Akova M, Bassetti M, De Waele JJ, Dimopoulos G, Kaukonen KM, Koulenti D, Martin C, Montravers P, Rello J, Rhodes A, Starr T, Wallis SC, Lipman J, Study D (2014) DALI: defining antibiotic levels in intensive care unit patients: are current beta-lactam antibiotic doses sufficient for critically ill patients? Clin Infect Dis 58:1072–1083CrossRefPubMed Roberts JA, Paul SK, Akova M, Bassetti M, De Waele JJ, Dimopoulos G, Kaukonen KM, Koulenti D, Martin C, Montravers P, Rello J, Rhodes A, Starr T, Wallis SC, Lipman J, Study D (2014) DALI: defining antibiotic levels in intensive care unit patients: are current beta-lactam antibiotic doses sufficient for critically ill patients? Clin Infect Dis 58:1072–1083CrossRefPubMed
3.
Zurück zum Zitat Li C, Du X, Kuti JL, Nicolau DP (2007) Clinical pharmacodynamics of meropenem in patients with lower respiratory tract infections. Antimicrob Agents Chemother 51:1725–1730CrossRefPubMedPubMedCentral Li C, Du X, Kuti JL, Nicolau DP (2007) Clinical pharmacodynamics of meropenem in patients with lower respiratory tract infections. Antimicrob Agents Chemother 51:1725–1730CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Roberts JA, Abdul-Aziz MH, Lipman J, Mouton JW, Vinks AA, Felton TW, Hope WW, Farkas A, Neely MN, Schentag JJ, Drusano G, Frey OR, Theuretzbacher U, Kuti JL (2014) Individualised antibiotic dosing for patients who are critically ill: challenges and potential solutions. Lancet Infect Dis 14:498–509CrossRefPubMedPubMedCentral Roberts JA, Abdul-Aziz MH, Lipman J, Mouton JW, Vinks AA, Felton TW, Hope WW, Farkas A, Neely MN, Schentag JJ, Drusano G, Frey OR, Theuretzbacher U, Kuti JL (2014) Individualised antibiotic dosing for patients who are critically ill: challenges and potential solutions. Lancet Infect Dis 14:498–509CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Dulhunty JM, Roberts JA, Davis JS, Webb SA, Bellomo R, Gomersall C, Shirwadkar C, Eastwood GM, Myburgh J, Paterson DL, Starr T, Paul SK, Lipman J (2015) A multicenter randomized trial of continuous versus intermittent beta-lactam infusion in severe sepsis. Am J Respir Crit Care Med 192:1298–1305CrossRefPubMed Dulhunty JM, Roberts JA, Davis JS, Webb SA, Bellomo R, Gomersall C, Shirwadkar C, Eastwood GM, Myburgh J, Paterson DL, Starr T, Paul SK, Lipman J (2015) A multicenter randomized trial of continuous versus intermittent beta-lactam infusion in severe sepsis. Am J Respir Crit Care Med 192:1298–1305CrossRefPubMed
6.
Zurück zum Zitat Heil EL, Nicolau DP, Farkas A, Roberts JA, Thom KA (2018) Pharmacodynamic target attainment for cefepime, meropenem, and piperacillin-tazobactam using a pharmacokinetic/pharmacodynamic-based dosing calculator in critically ill patients. Antimicrob Agents Chemother 62:e01008-18CrossRefPubMedPubMedCentral Heil EL, Nicolau DP, Farkas A, Roberts JA, Thom KA (2018) Pharmacodynamic target attainment for cefepime, meropenem, and piperacillin-tazobactam using a pharmacokinetic/pharmacodynamic-based dosing calculator in critically ill patients. Antimicrob Agents Chemother 62:e01008-18CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Bergen PJ, Bulitta JB, Kirkpatrick CMJ, Rogers KE, McGregor MJ, Wallis SC, Paterson DL, Nation RL, Lipman J, Roberts JA, Landersdorfer CB (2017) Substantial impact of altered pharmacokinetics in critically ill patients on the antibacterial effects of meropenem evaluated via the dynamic hollow-fiber infection model. Antimicrob Agents Chemother 61 Bergen PJ, Bulitta JB, Kirkpatrick CMJ, Rogers KE, McGregor MJ, Wallis SC, Paterson DL, Nation RL, Lipman J, Roberts JA, Landersdorfer CB (2017) Substantial impact of altered pharmacokinetics in critically ill patients on the antibacterial effects of meropenem evaluated via the dynamic hollow-fiber infection model. Antimicrob Agents Chemother 61
8.
Zurück zum Zitat Beumier M, Casu GS, Hites M, Wolff F, Cotton F, Vincent JL, Jacobs F, Taccone FS (2015) Elevated beta-lactam concentrations associated with neurological deterioration in ICU septic patients. Minerva Anestesiol 81:497–506PubMed Beumier M, Casu GS, Hites M, Wolff F, Cotton F, Vincent JL, Jacobs F, Taccone FS (2015) Elevated beta-lactam concentrations associated with neurological deterioration in ICU septic patients. Minerva Anestesiol 81:497–506PubMed
9.
Zurück zum Zitat Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O’Grady NP, Bartlett JG, Carratala J, El Solh AA, Ewig S, Fey PD, File TM Jr, Restrepo MI, Roberts JA, Waterer GW, Cruse P, Knight SL, Brozek JL (2016) Executive Summary: management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 63:575–582CrossRefPubMedPubMedCentral Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O’Grady NP, Bartlett JG, Carratala J, El Solh AA, Ewig S, Fey PD, File TM Jr, Restrepo MI, Roberts JA, Waterer GW, Cruse P, Knight SL, Brozek JL (2016) Executive Summary: management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 63:575–582CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP (2017) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP (2017) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med
11.
Zurück zum Zitat Valenza G, Seifert H, Decker-Burgard S, Laeuffer J, Morrissey I, Mutters R (2012) Comparative activity of carbapenem testing (COMPACT) study in Germany. Int J Antimicrob Agents 39:255–258CrossRefPubMed Valenza G, Seifert H, Decker-Burgard S, Laeuffer J, Morrissey I, Mutters R (2012) Comparative activity of carbapenem testing (COMPACT) study in Germany. Int J Antimicrob Agents 39:255–258CrossRefPubMed
12.
Zurück zum Zitat Mouton JW, Muller AE, Canton R, Giske CG, Kahlmeter G, Turnidge J (2018) MIC-based dose adjustment: facts and fables. J Antimicrob Chemother 73:564–568CrossRefPubMed Mouton JW, Muller AE, Canton R, Giske CG, Kahlmeter G, Turnidge J (2018) MIC-based dose adjustment: facts and fables. J Antimicrob Chemother 73:564–568CrossRefPubMed
13.
Zurück zum Zitat Pea F, Viale P, Cojutti P, Furlanut M (2012) Dosing nomograms for attaining optimum concentrations of meropenem by continuous infusion in critically ill patients with severe gram-negative infections: a pharmacokinetics/pharmacodynamics-based approach. Antimicrob Agents Chemother 56:6343–6348CrossRefPubMedPubMedCentral Pea F, Viale P, Cojutti P, Furlanut M (2012) Dosing nomograms for attaining optimum concentrations of meropenem by continuous infusion in critically ill patients with severe gram-negative infections: a pharmacokinetics/pharmacodynamics-based approach. Antimicrob Agents Chemother 56:6343–6348CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Wong G, Briscoe S, McWhinney B, Ally M, Ungerer J, Lipman J, Roberts JA (2018) Therapeutic drug monitoring of b-lactam antibiotics in the critically ill: direct measurement of unbound drug concentrations to achieve appropriate drug exposures. J Antimicrob Chemother in press Wong G, Briscoe S, McWhinney B, Ally M, Ungerer J, Lipman J, Roberts JA (2018) Therapeutic drug monitoring of b-lactam antibiotics in the critically ill: direct measurement of unbound drug concentrations to achieve appropriate drug exposures. J Antimicrob Chemother in press
15.
Zurück zum Zitat Neely MN, Kato L, Youn G, Kraler L, Bayard D, van Guilder M, Schumitzky A, Yamada W, Jones B, Minejima E (2018) Prospective trial on the use of trough concentration versus area under the curve to determine therapeutic vancomycin dosing. Antimicrob Agents Chemother 62 Neely MN, Kato L, Youn G, Kraler L, Bayard D, van Guilder M, Schumitzky A, Yamada W, Jones B, Minejima E (2018) Prospective trial on the use of trough concentration versus area under the curve to determine therapeutic vancomycin dosing. Antimicrob Agents Chemother 62
Metadaten
Titel
Personalized antibiotic dosing for the critically ill
verfasst von
Jason A. Roberts
Claire Roger
Jan J. De Waele
Publikationsdatum
14.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 5/2019
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05522-3

Weitere Artikel der Ausgabe 5/2019

Intensive Care Medicine 5/2019 Zur Ausgabe

What's New in Intensive Care

Norepinephrine in septic shock

From the Inside

A thirty second pause

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.