TY - JOUR
T1 - Advances in antibiotic therapy in the critically ill
AU - Vincent, Jean Louis
AU - Bassetti, Matteo
AU - François, Bruno
AU - Karam, George
AU - Chastre, Jean
AU - Torres, Antoni
AU - Roberts, Jason A.
AU - Taccone, Fabio S.
AU - Rello, Jordi
AU - Calandra, Thierry
AU - De Backer, Daniel
AU - Welte, Tobias
AU - Antonelli, Massimo
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
KW - Anti-Bacterial Agents
KW - Critical Care and Intensive Care Medicine
KW - Critical Illness
KW - Humans
KW - Anti-Bacterial Agents
KW - Critical Care and Intensive Care Medicine
KW - Critical Illness
KW - Humans
UR - https://publicatt.unicatt.it/handle/10807/92704
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84971342966&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84971342966&origin=inward
U2 - 10.1186/s13054-016-1285-6
DO - 10.1186/s13054-016-1285-6
M3 - Article
SN - 1364-8535
VL - 20
SP - 133
EP - 138
JO - Critical Care
JF - Critical Care
IS - 1
ER -