Deep Dive: Advances in the Care of Infectious Diseases in the ICU-Optimizing Antimicrobial Drug Use in Critical Illness

Video Transcription

Video Summary

In this video, Kirsten Kota, a medical and surgical trauma ICU pharmacist, discusses the impact of critical illness on antimicrobial pharmacokinetics and pharmacodynamics. She focuses on two main concepts: baseline physiology and antimicrobial interactions, and the acute physiologic changes in critical illness.<br /><br />She explains that pharmacokinetics refers to the movement of drugs through the body, while pharmacodynamics refers to the drug's interaction with its target receptor or site of action. She also discusses protein binding and volume distribution.<br /><br />Kota addresses the challenges in dosing antibiotics in critically ill patients with hypoalbuminemia and augmented renal clearance. She suggests using aggressive dosing and optimizing pharmacokinetic targets by adjusting the dose, increasing the dosing interval, or changing the antibiotic.<br /><br />She also explains the impact of continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO) on antimicrobial pharmacokinetics. She recommends considering higher loading doses and extended or continuous infusions for certain antibiotics.<br /><br />Lastly, she briefly mentions the impact of molecular adsorbent recirculating systems (MARS) on medication removal and suggests adjusting dosages based on protein binding and volume distribution.<br /><br />Overall, Kota emphasizes the importance of individualizing antibiotic dosing in critically ill patients and working closely with pharmacists for guidance in optimizing therapy.

Asset Caption

Kirstin Kooda

Keywords

critical illness

antimicrobial pharmacokinetics

pharmacodynamics

protein binding

volume distribution

dosing antibiotics

continuous renal replacement therapy

pharmacists

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