Pharmacokinetics of Antibiotics in Critically Ill Patients

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 1990 Jan 1

PMID 2289997

Citations 27

Authors

R van Dalen

T B Vree

Affiliations

Soon will be listed here.

Abstract

Differences in pharmacokinetic data of aminoglycosides, ceftazidime and ceftriaxone between intensive care patients and volunteers or patients who are less severely ill, are described. Similar differences are observed for midazolam. In severely ill patients with normal renal function a wide interpatient variability of aminoglycoside half-life (t1/2) and increased distribution volume (Vd) are observed. This results in inadequate serum levels. A pharmacokinetic approach of drug dosing, based on serum concentrations in individual patients, is advised. For ceftazidime and ceftriaxone similar changes of t1/2 and Vd are observed. Since protein binding is frequently reduced in severely ill patients, the influence of altered binding of highly bound drugs on Vd and drug clearance is discussed. As both may be increased by reduced protein binding, the change of t1/2 to be expected is unpredictable. Dosing regimens should be based on pharmacokinetic data derived from patients whose severity of disease is comparable to that of the patients to be treated.

Citing Articles

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Optimizing the Use of Beta-Lactam Antibiotics in Clinical Practice: A Test of Time.

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Evaluation of Amikacin Pharmacokinetics in Critically Ill Patients with Intra-abdominal Sepsis.

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Single-dose and Steady-state Pharmacokinetics of Vancomycin in Critically Ill Patients Admitted to Medical Intensive Care Unit of India.

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Amikacin in Critically Ill Patients: A Review of Population Pharmacokinetic Studies.

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