Prolonged administration of β-lactam antibiotics – a comprehensive review and critical appraisal | Zendy

Michael Osthoff | Zendy; Martin Siegemund | Zendy; G Balestra | Zendy; Mohd H. AbdulAziz | Zendy; Jason A. Roberts | Zendy

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Prolonged administration of β-lactam antibiotics – a comprehensive review and critical appraisal

Author(s) -

Michael Osthoff,

Martin Siegemund,

G Balestra,

Mohd H. AbdulAziz,

Jason A. Roberts

Publication year - 2016

Publication title -

schweizerische medizinische wochenschrift

Language(s) - English

Resource type - Journals

ISSN - 0036-7672

DOI - 10.4414/smw.2016.14368

Subject(s) - medicine , antibiotics , dosing , pharmacokinetics , pharmacodynamics , intensive care medicine , volume of distribution , bolus (digestion) , placebo , observational study , anesthesia , pharmacology , alternative medicine , pathology , microbiology and biotechnology , biology

Prolonged infusion of β-lactam antibiotics as either extended (over at least 2 hours) or continuous infusion is increasingly applied in intensive care units around the world in an attempt to optimise treatment with this most commonly used class of antibiotics, whose effectiveness is challenged by increasing resistance rates. The pharmacokinetics of β-lactam antibiotics in critically ill patients is profoundly altered secondary to an increased volume of distribution and the presence of altered renal function, including augmented renal clearance. This may lead to a significant decrease in plasma concentrations of β-lactam antibiotics. As a consequence, low pharmacokinetic/pharmacodynamic (PK/PD) target attainment, which is described as the percentage of time that the free drug concentration is maintained above the minimal inhibitory concentration (MIC) of the causative organism (fT

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