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Review
. 2024 Oct 4;28(1):326.
doi: 10.1186/s13054-024-05101-z.

A narrative review on antimicrobial dosing in adult critically ill patients on extracorporeal membrane oxygenation

Myeongji Kim  1 , Maryam Mahmood  2 , Lynn L Estes  3 , John W Wilson  2 , Nathaniel J Martin  3 , Joseph E Marcus  4   5 , Ankit Mittal  6 , Casey R O'Connell  3 , Aditya Shah  2
Affiliations
Review

A narrative review on antimicrobial dosing in adult critically ill patients on extracorporeal membrane oxygenation

Myeongji Kim et al. Crit Care. .

Abstract

The optimal dosing strategy of antimicrobial agents in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) is unknown. We conducted comprehensive review of existing literature on effect of ECMO on pharmacokinetics and pharmacodynamics of antimicrobials, including antibacterials, antifungals, and antivirals that are commonly used in critically ill patients. We aim to provide practical guidance to clinicians on empiric dosing strategy for these patients. Finally, we discuss importance of therapeutic drug monitoring, limitations of current literature, and future research directions.

Keywords: Antimicrobial dosing; Extracorporeal membrane oxygenation; Pharmacokinetics; Therapeutic drug monitoring.

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Conflict of interest statement

The authors declare no competing interests.

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