18f3f9f69a4b5e6be732a351974b3f62 302798.pdf 7517d0f0924a059b78691a9d712ad584a8ad02ec 302798.pdf 7a9526ddab79ea480edbb9cb9f0f04288c9b8bb1df9abbdfbc8def0953e19e06 302798.pdf Title: Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria Subject: 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. Keywords: pharmacokinetics; antibiotic resistance; antibiotic activity; intensive care unit; multidrug-resistant pathogens Author: Jesus Ruiz-Ramos, Laura Gras-Martín and Paula Ramírez Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Mar 8 06:52:45 2023 CET ModDate: Wed Mar 8 06:55:06 2023 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 346478 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OPZDHV+VnURWPalladioL Type 1 Custom yes yes no 10 0 NGGDHU+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 WBUORX+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 AZYNWV+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 WLENKM+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 47 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 69 0 DJQPZW+CMSY10 Type 1 Builtin yes yes no 73 0 CRJHCU+PazoMath-Italic Type 1 Builtin yes yes no 92 0 JDUVMV+TeX-tipa9 Type 1 Builtin yes yes no 105 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-11-12 02:45:13 CET RepresentationInformation: 302798.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-11-11 09:47:58 CET Size: 346478 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 435 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Pharmacokinetic Variations in Critical Patients Destination: section.2 Item: Title: Renal Replacement Therapy Destination: section.3 Item: Title: Extracorporeal Membrane Oxygenation Destination: section.4 Item: Title: Antibiotic Therapeutic Drug Monitoring Destination: section.5 Item: Title: Pk/Pd to Suppress the Emergence of Bacterial Resistance Destination: section.6 Children: Item: Title: -Lactams Destination: subsection.6.1 Item: Title: Fluoroquinolones Destination: subsection.6.2 Item: Title: Aminoglycosides Destination: subsection.6.3 Item: Title: Fosfomycin Destination: subsection.6.4 Item: Title: Colistin Destination: subsection.6.5 Item: Title: Linezolid Destination: subsection.6.6 Item: Title: Daptomycin Destination: subsection.6.7 Item: Title: Glycopeptides Destination: subsection.6.8 Item: Title: Machine Learning, Big Data, and Artificial Intelligence Destination: section.7 Children: Item: Title: Big Data Analysis Destination: subsection.7.1 Item: Title: Bedside Antibiotic Monitoring Systems Destination: subsection.7.2 Item: Title: Conclusions Destination: section.8 Item: Title: References Destination: section.8 Info: Title: Antimicrobial Pharmacokinetics and Pharmacodynamics in Critical Care: Adjusting the Dose in Extracorporeal Circulation and to Prevent the Genesis of Multiresistant Bacteria Author: Jesus Ruiz-Ramos, Laura Gras-Martín and Paula Ramírez Subject: 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. 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