Title |
Therapeutic drug monitoring of anti-infective agents in critically ill patients
|
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Published in |
Expert Review of Clinical Pharmacology, April 2016
|
DOI | 10.1586/17512433.2016.1172209 |
Pubmed ID | |
Authors |
Nynke G. L. Jager, Reinier M. van Hest, Jeffrey Lipman, Fabio S. Taccone, Jason A. Roberts |
Abstract |
Initial adequate anti-infective therapy is associated with significantly improved clinical outcomes for patients with severe infections. However, in critically ill patients, several pathophysiological and/or iatrogenic factors may affect the pharmacokinetics of anti-infective agents leading to suboptimal drug exposure, in particular during the early phase of therapy. Therapeutic drug monitoring (TDM) may assist to overcome this problem. We discuss the available evidence on the use of TDM in critically ill patient populations for a number of anti-infective agents, including aminoglycosides, β-lactams, glycopeptides, antifungals and antivirals. Also, we present the available evidence on the practices of anti-infective TDM and describe the potential utility of TDM to improve treatment outcome in critically ill patients with severe infections. For aminoglycosides, glycopeptides and voriconazole, beneficial effects of TDM have been established on both drug effectiveness and potential side effects. However, for other drugs, therapeutic ranges need to be further defined to optimize treatment prescription in this setting. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Spain | 8 | 26% |
United Kingdom | 6 | 19% |
India | 1 | 3% |
Canada | 1 | 3% |
United States | 1 | 3% |
Unknown | 14 | 45% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 18 | 58% |
Practitioners (doctors, other healthcare professionals) | 7 | 23% |
Science communicators (journalists, bloggers, editors) | 5 | 16% |
Scientists | 1 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 1% |
Germany | 1 | 1% |
Canada | 1 | 1% |
Unknown | 90 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 15 | 16% |
Researcher | 13 | 14% |
Student > Ph. D. Student | 12 | 13% |
Other | 7 | 8% |
Student > Postgraduate | 7 | 8% |
Other | 13 | 14% |
Unknown | 26 | 28% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 23 | 25% |
Pharmacology, Toxicology and Pharmaceutical Science | 21 | 23% |
Chemistry | 4 | 4% |
Biochemistry, Genetics and Molecular Biology | 4 | 4% |
Agricultural and Biological Sciences | 3 | 3% |
Other | 8 | 9% |
Unknown | 30 | 32% |