Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper

This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in critically ill adult patients in the intensive care unit (ICU). This Position Paper also provides a practical guide on how TDM can be applied in rou...

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Veröffentlicht in:Intensive care medicine Jg. 46; H. 6; S. 1127 - 1153
Hauptverfasser: Abdul-Aziz, Mohd H., Alffenaar, Jan-Willem C., Bassetti, Matteo, Bracht, Hendrik, Dimopoulos, George, Marriott, Deborah, Neely, Michael N., Paiva, Jose-Artur, Pea, Federico, Sjovall, Fredrik, Timsit, Jean F., Udy, Andrew A., Wicha, Sebastian G., Zeitlinger, Markus, De Waele, Jan J., Roberts, Jason A.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Springer Nature B.V 01.06.2020
Springer Berlin Heidelberg
Schlagworte:
Adult
Amides
Aminoglycosides
Anti-Bacterial Agents - therapeutic use
Anti-Infective Agents
Antibiotics
Antifungal agents
Antiinfectives and antibacterials
Antimicrobial agents
Antiviral agents
Antiviral drugs
beta-Lactams
Chemotherapy
Clinical microbiology
Conference Report and Expert Panel
Critical Illness
Drug Monitoring
Humans
Infectious diseases
Intensive care
Linezolid
Literature reviews
Microbiology
Monitoring
Patients
Pharmacodynamics
Pharmacokinetics
Pharmacology
Ribavirin
Sepsis
Target recognition
Teicoplanin
Therapeutic applications
Therapeutic drug monitoring
Therapeutic targets
Toxicology
Vancomycin
Voriconazole
β-Lactam antibiotics
Antifungals
Sepsis
Antibacterials
Pharmacodynamics
Pharmacokinetics
Antivirals
ISSN:0342-4642, 1432-1238, 1432-1238
Online-Zugang:Volltext
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Beschreibung
Zusammenfassung:This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in critically ill adult patients in the intensive care unit (ICU). This Position Paper also provides a practical guide on how TDM can be applied in routine clinical practice to improve therapeutic outcomes in critically ill adult patients. Literature review and analysis were performed by Panel Members nominated by the endorsing organisations, European Society of Intensive Care Medicine (ESICM), Pharmacokinetic/Pharmacodynamic and Critically Ill Patient Study Groups of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), International Association for Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT) and International Society of Antimicrobial Chemotherapy (ISAC). Panel members made recommendations for whether TDM should be applied clinically for different antimicrobials/classes. TDM-guided dosing has been shown to be clinically beneficial for aminoglycosides, voriconazole and ribavirin. For most common antibiotics and antifungals in the ICU, a clear therapeutic range has been established, and for these agents, routine TDM in critically ill patients appears meritorious. For the antivirals, research is needed to identify therapeutic targets and determine whether antiviral TDM is indeed meritorious in this patient population. The Panel Members recommend routine TDM to be performed for aminoglycosides, beta-lactam antibiotics, linezolid, teicoplanin, vancomycin and voriconazole in critically ill patients. Although TDM should be the standard of care for most antimicrobials in every ICU, important barriers need to be addressed before routine TDM can be widely employed worldwide.
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ISSN:0342-4642
1432-1238
1432-1238
DOI:10.1007/s00134-020-06050-1