Deep Dive: Advances in the Care of Infectious Diseases in the ICU-Advances in the Care of Infectious Diseases in the ICU Handout

Advances in the Care of Infectious Diseases in the ICU Handout

Pdf Summary

The document discusses the impact of critical illness on antimicrobial pharmacokinetics and pharmacodynamics. Critical illness can affect the volume of distribution, protein binding, and augmented renal clearance of antimicrobials, leading to altered drug behavior in the body. For example, the volume of distribution may increase due to fluid shifts in sepsis, while protein binding may be affected by albumin as an acute phase reactant. Augmented renal clearance may occur in critically ill patients, leading to enhanced drug clearance. Changes in pharmacokinetics can impact the efficacy of antimicrobials, and failure to account for these changes can result in suboptimal dosing and poor patient outcomes. The document suggests that loading doses of hydrophilic antibiotics should be used in critically ill patients, as these drugs have a low volume of distribution and lower penetration into tissues. The document also highlights the importance of considering factors such as obesity, renal replacement therapies, and extracorporeal membrane oxygenation (ECMO) when optimizing antimicrobial drug use in critical illness. Overall, the document emphasizes the need for individualized and aggressive dosing strategies, as well as close collaboration with pharmacists, to ensure optimal antimicrobial therapy in critically ill patients.

Keywords

critical illness

antimicrobial pharmacokinetics

volume of distribution

protein binding

augmented renal clearance

fluid shifts

loading doses

hydrophilic antibiotics

pharmacodynamics

pharmacokinetics

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