b0931d0c5a56b8f4be787d5fbaf83371 pmc_11428266.pdf b365d6163128a4499f7a925671b37ad0ecd95ed2 pmc_11428266.pdf 58efd95ac5d8cad7d450bea68dc9b78746da00b75fa01f8372bc950f16f38d18 pmc_11428266.pdf Title: Risk Factors Associated with Antibiotic Exposure Variability in Critically Ill Patients: A Systematic Review Subject: (1) Background: Knowledge about the behavior of antibiotics in critically ill patients has been increasing in recent years. Some studies have concluded that a high percentage may be outside the therapeutic range. The most likely cause of this is the pharmacokinetic variability of critically ill patients, but it is not clear which factors have the greatest impact. The aim of this systematic review is to identify risk factors among critically ill patients that may exhibit significant pharmacokinetic alterations, compromising treatment efficacy and safety. (2) Methods: The search included the PubMed, Web of Science, and Embase databases. (3) Results: We identified 246 observational studies and ten clinical trials. The most studied risk factors in the literature were renal function, weight, age, sex, and renal replacement therapy. Risk factors with the greatest impact included renal function, weight, renal replacement therapy, age, protein or albumin levels, and APACHE or SAPS scores. (4) Conclusions: The review allows us to identify which critically ill patients are at a higher risk of not reaching therapeutic targets and helps us to recognize the extensive number of risk factors that have been studied, guiding their inclusion in future studies. It is essential to continue researching, especially in real clinical practice and with clinical outcomes. Keywords: pharmacokinetics; pharmacodynamics; critically ill patients; antibiotic; exposure; target attainment; risk factors Author: Laura Gras-Martín, Adrián Plaza-Diaz, Borja Zarate-Tamames, Paula Vera-Artazcoz, Olga H. Torres, Carla Bastida, Dolors Soy and Jesús Ruiz-Ramos Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Sep 5 08:31:33 2024 CEST ModDate: Thu Sep 5 08:35:02 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 27 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2668964 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JGBJTI+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 YYCHUZ+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 TYKJFN+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 ZSLMCC+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 MDAOUY+VnURWPalladioL Type 1 Custom yes yes yes 32 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 52 0 LDNDFG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 80 0 LDNDFH+PalatinoLinotype CID TrueType Identity-H yes yes yes 83 0 LDNDFI+PalatinoLinotype TrueType WinAnsi yes yes no 89 0 LDNDFK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 92 0 LDNDLJ+PalatinoLinotype TrueType MacRoman yes yes no 95 0 LDNDFG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 122 0 LDNDFI+PalatinoLinotype TrueType WinAnsi yes yes no 125 0 LDNDFK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 128 0 LDNDFG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 143 0 LDNDFH+PalatinoLinotype CID TrueType Identity-H yes yes yes 146 0 LDNDFI+PalatinoLinotype TrueType WinAnsi yes yes no 152 0 LDNDFK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 155 0 LDNDLJ+PalatinoLinotype TrueType MacRoman yes yes no 158 0 LDNDFG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 170 0 LDNDFH+PalatinoLinotype CID TrueType Identity-H yes yes yes 173 0 LDNDFI+PalatinoLinotype TrueType WinAnsi yes yes no 179 0 LDNDFK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 182 0 LDNDLJ+PalatinoLinotype TrueType MacRoman yes yes no 185 0 LWLIVD+EURM10 Type 1 Builtin yes yes yes 192 0 SGZPHO+VnURWPalladioL-Italic Type 1 Custom yes yes yes 207 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-10 02:43:23 CEST RepresentationInformation: pmc_11428266.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-10-09 02:36:32 CEST Size: 2668964 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 736 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Item: Title: Discussion Destination: section.3 Item: Title: Materials and Methods Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Risk Factors Associated with Antibiotic Exposure Variability in Critically Ill Patients: A Systematic Review Author: Laura Gras-Martín, Adrián Plaza-Diaz, Borja Zarate-Tamames, Paula Vera-Artazcoz, Olga H. Torres, Carla Bastida, Dolors Soy and Jesús Ruiz-Ramos Subject: (1) Background: Knowledge about the behavior of antibiotics in critically ill patients has been increasing in recent years. Some studies have concluded that a high percentage may be outside the therapeutic range. The most likely cause of this is the pharmacokinetic variability of critically ill patients, but it is not clear which factors have the greatest impact. The aim of this systematic review is to identify risk factors among critically ill patients that may exhibit significant pharmacokinetic alterations, compromising treatment efficacy and safety. (2) Methods: The search included the PubMed, Web of Science, and Embase databases. (3) Results: We identified 246 observational studies and ten clinical trials. The most studied risk factors in the literature were renal function, weight, age, sex, and renal replacement therapy. Risk factors with the greatest impact included renal function, weight, renal replacement therapy, age, protein or albumin levels, and APACHE or SAPS scores. (4) Conclusions: The review allows us to identify which critically ill patients are at a higher risk of not reaching therapeutic targets and helps us to recognize the extensive number of risk factors that have been studied, guiding their inclusion in future studies. It is essential to continue researching, especially in real clinical practice and with clinical outcomes. 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