Advances in antibiotic therapy in the critically ill
Vincent, Jean-Louis (Université libre de Bruxelles)
Bassetti, Matteo (Santa Maria Misericordia University Hospital)
François, Bruno (Service de Réanimation Polyvalente (França))
Karam, George (Louisiana State University School of Medicine (Estats Units d'Amèrica))
Chastre, Jean (Groupe Hospitalier Pitié-Salpêtrière)
Torres, Antoni (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Roberts, Jason A. (The University of Queensland)
Taccone, Fabio Silvio (Université libre de Bruxelles)
Rello, Jordi (Hospital Universitari Vall d'Hebron)
Calandra, Thierry (University of Lausanne)
De Backer, Daniel (Université Libre de Bruxelles)
Welte, Tobias (Medizinische Hochschule)
Antonelli, Massimo (Catholic University of Rome)
Universitat Autònoma de Barcelona

Data:	2016
Resum:	Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation. Antibiotic pharmacodynamics and pharmacokinetics, notably volumes of distribution and clearance, can be altered by critical illness and can influence dosing regimens. Dosing decisions in different subgroups of patients, e. g. , the obese, are also covered. We also briefly consider ventilator-associated pneumonia and the role of inhaled antibiotics. Finally, we mention antibiotics that are currently being developed and show promise for the future.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Critical care, Vol. 20 (may 2016) , ISSN 1466-609X

DOI: 10.1186/s13054-016-1285-6
PMID: 27184564

13 p, 993.7 KB

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