A narrative review of predictors for β-lactam antibiotic exposure during empirical treatment in critically ill patients.

Autor:	Abdulla A; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands., Ewoldt TMJ; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands., Purmer IM; Department of Intensive Care, Haga Hospital, The Hague, The Netherlands., Muller AE; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Medical Microbiology, Haaglanden Medical Center, The Hague, The Netherlands., Gommers D; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands., Endeman H; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands., Koch BCP; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Expert opinion on drug metabolism & toxicology [Expert Opin Drug Metab Toxicol] 2021 Apr; Vol. 17 (4), pp. 359-368. Date of Electronic Publication: 2021 Feb 02.
DOI:	10.1080/17425255.2021.1879049
Abstrakt:	Introduction: : Emerging studies suggest that antibiotic pharmacokinetics (PK) are difficult to predict in critically ill patients. The high intra- and inter-patient PK variability makes it challenging to accurately predict the appropriate dosage required for a given patient. Identifying patients at risk could help clinicians to consider more individualized dosing regimens and perform therapeutic drug monitoring. We provide an overview of relevant predictors associated with target (non-)attainment of β-lactam antibiotics in critically ill patients. Areas Covered: : This narrative review summarizes patient and clinical characteristics that can help to predict the attainment of target serum concentrations and to provide guidance on antimicrobial dose optimization. Literature was searched using Embase and Medline database, focusing on β-lactam antibiotics in critically ill patients. Expert Opinion: : Adequate concentration attainment can be anticipated in critically ill patients prior to initiating empiric β-lactam antibiotic therapy based on readily available demographic and clinical factors. Male gender, younger age, and augmented renal clearance were the most significant predictors for target non-attainment and should be considered in further investigations to develop dosing algorithms for optimal β-lactam therapy.
Databáze:	MEDLINE
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