Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Oct 1;30(5):439-447.
doi: 10.1097/MCC.0000000000001187. Epub 2024 Jul 5.

Antibiotic dose optimisation in the critically ill: targets, evidence and future strategies

Christopher J Dyer  1   2   3 , Jan J De Waele  4   5 , Jason A Roberts  1   2   3   6
Affiliations
Review

Antibiotic dose optimisation in the critically ill: targets, evidence and future strategies

Christopher J Dyer et al. Curr Opin Crit Care. .

Abstract

Purpose of review: To highlight the recent evidence for antibiotic pharmacokinetics and pharmacodynamics (PK/PD) in enhancing patient outcomes in sepsis and septic shock. We also summarise the limitations of available data and describe future directions for research to support translation of antibiotic dose optimisation to the clinical setting.

Recent findings: Sepsis and septic shock are associated with poor outcomes and require antibiotic dose optimisation, mostly due to significantly altered pharmacokinetics. Many studies, including some randomised controlled trials have been conducted to measure the clinical outcome effects of antibiotic dose optimisation interventions including use of therapeutic drug monitoring. Current data support antibiotic dose optimisation for the critically ill. Further investigation is required to evolve more timely and robust precision antibiotic dose optimisation approaches, and to clearly quantify whether any clinical and health-economic benefits support expanded use of this treatment intervention.

Summary: Antibiotic dose optimisation appears to improve outcomes in critically ill patients with sepsis and septic shock, however further research is required to quantify the level of benefit and develop a stronger knowledge of the role of new technologies to facilitate optimised dosing.

PubMed Disclaimer

References

    1. Rosenthal VD, Yin R, Lu Y, et al. The impact of healthcare-associated infections on mortality in ICU: a prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East. Am J Infect Control 2023; 51:675–682.
    1. Blot S, Ruppe E, Harbarth S, et al. Healthcare-associated infections in adult intensive care unit patients: changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive Crit Care Nurs 2022; 70:103227.
    1. Bauer M, Gerlach H, Vogelmann T, et al. Mortality in sepsis and septic shock in Europe, North America and Australia between 2009 and 2019 – results from a systematic review and meta-analysis. Crit Care 2020; 24:239.
    1. Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med 2021; 47:1181–1247.
    1. Guilhaumou R, Benaboud S, Bennis Y, et al. Optimization of the treatment with beta-lactam antibiotics in critically ill patients-guidelines from the French Society of Pharmacology and Therapeutics (Societe Francaise de Pharmacologie et Therapeutique-SFPT) and the French Society of Anaesthesia and Intensive Care Medicine (Societe Francaise d’Anesthesie et Reanimation-SFAR). Crit Care 2019; 23:104.

MeSH terms

Substances