Pharmakokinetik und Pharmakodynamik von Antibiotika in der Intensivmedizin

Translated title of the contribution: Pharmacokinetics and pharmacodynamics of antibiotics in intensive care

F. Sorgel, R. Höhl, R. Glaser, C. Stelzer, M. Munz, M. Vormittag, M. Kinzig, J. Bulitta, C. Landersdorfer, A. Junger, M. Christ, M. Wilhelm, U. Holzgrabe

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Optimized dosage regimens of antibiotics have remained obscure since their introduction. During the last two decades pharmacokinetic(PK)-pharmacodynamic(PD) relationships, originally established in animal experiments, have been increasingly used in patients. The action of betalactams is believed to be governed by the time the plasma concentration is above the minimum inhibitory concentration (MIC). Aminoglycosides act as planned when the peak concentration is a multiple of the MIC and vancomycin seems to work best when the area under the plasma vs. time curve (AUC) to MIC has a certain ratio. Clinicians should be aware that these relationships can only be an indication in which direction dosing should go. Larger studies with sufficiently high numbers of patients and particularly severely sick patients are needed to prove the concepts. In times where all antibiotics can be measured with new technologies, the introduction of therapeutic drug monitoring (TDM) is suggested for ICUs (Intensive Care Unit). The idea of a central lab for TDM of antibiotics such as PEAK (Paul Ehrlich Antibiotika Konzentrationsmessung) is supported.

Translated title of the contributionPharmacokinetics and pharmacodynamics of antibiotics in intensive care
Original languageGerman
Pages (from-to)11-22
Number of pages12
JournalMedizinische Klinik - Intensivmedizin und Notfallmedizin
Volume112
Issue number1
DOIs
Publication statusPublished - Feb 2017

Keywords

  • Antibiotics
  • Critically ill
  • Mass spectrometry
  • Penicillin
  • Therapeutic drug monitoring

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