Therapeutic drug monitoring of anti-infective agents in critically ill patients
Autor: | Jeffrey Lipman, Fabio Silvio Taccone, Reinier M. van Hest, Nynke G L Jager, Jason A. Roberts |
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Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
Drug medicine.medical_specialty medicine.drug_class Critical Illness media_common.quotation_subject 030106 microbiology Antibiotics Infections 03 medical and health sciences Anti-Infective Agents Pharmacokinetics Intensive care medicine Animals Humans Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics Medical prescription Intensive care medicine media_common Voriconazole medicine.diagnostic_test business.industry General Medicine Treatment Outcome Therapeutic drug monitoring Drug Monitoring business medicine.drug |
Zdroj: | Expert Review of Clinical Pharmacology. 9:961-979 |
ISSN: | 1751-2441 1751-2433 |
Popis: | Initial adequate anti-infective therapy is associated with significantly improved clinical outcomes for patients with severe infections. However, in critically ill patients, several pathophysiological and/or iatrogenic factors may affect the pharmacokinetics of anti-infective agents leading to suboptimal drug exposure, in particular during the early phase of therapy. Therapeutic drug monitoring (TDM) may assist to overcome this problem. We discuss the available evidence on the use of TDM in critically ill patient populations for a number of anti-infective agents, including aminoglycosides, β-lactams, glycopeptides, antifungals and antivirals. Also, we present the available evidence on the practices of anti-infective TDM and describe the potential utility of TDM to improve treatment outcome in critically ill patients with severe infections. For aminoglycosides, glycopeptides and voriconazole, beneficial effects of TDM have been established on both drug effectiveness and potential side effects. However, for other drugs, therapeutic ranges need to be further defined to optimize treatment prescription in this setting. |
Databáze: | OpenAIRE |
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