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The role of infecti...
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Tängdén, ThomasUppsala universitet,Infektionssjukdomar
(author)
The role of infection models and PK/PD modelling for optimising care of critically ill patients with severe infections
- Article/chapterEnglish2017
Publisher, publication year, extent ...
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2017-04-13
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Springer Science and Business Media LLC,2017
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-333824
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-333824URI
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https://doi.org/10.1007/s00134-017-4780-6DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:for swepub-publicationtype
Notes
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Critically ill patients with severe infections are at high risk of suboptimal antimicrobial dosing. The pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in these patients differ significantly from the patient groups from whose data the conventional dosing regimens were developed. Use of such regimens often results in inadequate antimicrobial concentrations at the site of infection and is associated with poor patient outcomes. In this article, we describe the potential of in vitro and in vivo infection models, clinical pharmacokinetic data and pharmacokinetic/ pharmacodynamic models to guide the design of more effective antimicrobial dosing regimens. Individualised dosing, based on population PK models and patient factors (e.g. renal function and weight) known to influence antimicrobial PK, increases the probability of achieving therapeutic drug exposures while at the same time avoiding toxic concentrations. When therapeutic drug monitoring (TDM) is applied, early dose adaptation to the needs of the individual patient is possible. TDM is likely to be of particular importance for infected critically ill patients, where profound PK changes are present and prompt appropriate antibiotic therapy is crucial. In the light of the continued high mortality rates in critically ill patients with severe infections, a paradigm shift to refined dosing strategies for antimicrobials is warranted to enhance the probability of achieving drug concentrations that increase the likelihood of clinical success.
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Martin, V. RamosUniv Liverpool, Dept Mol & Clin Pharmacol, Liverpool, Merseyside, England.
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Felton, T. W.Univ South Manchester Hosp, Intens Care Unit, Manchester, Lancs, England.
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Nielsen, Elisabet I.,1973-Uppsala universitet,Institutionen för farmaceutisk biovetenskap(Swepub:uu)elnie838
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Marchand, S.INSERM, Pole Biol St, U1070, Poitiers, France.;Univ Poitiers, UFR Med Pharm, Poitiers, France.
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Brueggemann, R. J.Radboud Univ Nijmegen, Med Ctr, Dept Pharm, Nijmegen, Netherlands.
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Bulitta, J. B.Univ Florida, Coll Pharm, Ctr Pharmacometr & Syst Pharmacol, Orlando, FL USA.
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Bassetti, M.Santa Maria Misericordia Univ Hosp, Div Infect Dis, Udine, Italy.;Univ Udine, Udine, Italy.
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Theuretzbacher, U.Ctr Anti Infect Agents, Vienna, Austria.
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Tsuji, B. T.SUNY Buffalo, Sch Pharm & Pharmaceut Sci, Buffalo, NY USA.
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Wareham, D. W.Queen Mary Univ London, Barts & London Sch Med & Dent, Antimicrobial Res Grp, London, England.
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Friberg, Lena EUppsala universitet,Institutionen för farmaceutisk biovetenskap(Swepub:uu)lenasimo
(author)
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De Waele, J. J.Ghent Univ Hosp, Dept Crit Care Med, Ghent, Belgium.
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Tam, V. H.Univ Houston, Coll Pharm, Dept Pharm Practice & Translat Res, Houston, TX USA.
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Roberts, Jason A.Univ Queensland, Trauma & Crit Care Res Ctr, Burns, Brisbane, Qld, Australia.;Univ Queensland, Ctr Translat Antiinfect Pharmacodynam, Brisbane, Qld, Australia.;Royal Brisbane & Womens Hosp, Dept Intens Care Med & Pharm, Level 3,Ned Hanlon Bldg, Brisbane, Qld 4029, Australia.
(author)
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Uppsala universitetInfektionssjukdomar
(creator_code:org_t)
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In:Intensive Care Medicine: Springer Science and Business Media LLC43:7, s. 1021-10320342-46421432-1238
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Tängdén, Thomas
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Martin, V. Ramos
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Felton, T. W.
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Nielsen, Elisabe ...
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Marchand, S.
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Brueggemann, R. ...
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Bulitta, J. B.
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Bassetti, M.
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Theuretzbacher, ...
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Tsuji, B. T.
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Wareham, D. W.
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Friberg, Lena E
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De Waele, J. J.
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Tam, V. H.
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Roberts, Jason A ...
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