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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Vydané v:	Intensive care medicine Ročník 46; číslo 6; s. 1127 - 1153
Hlavní autori:	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.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Springer Nature B.V 01.06.2020 Springer Berlin Heidelberg
Predmet:	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
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Abstract	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.
AbstractList	PurposeThis 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. MethodsLiterature 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.ResultsTDM-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.ConclusionAlthough 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. 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. 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.PURPOSEThis 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.METHODSLiterature 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.RESULTSTDM-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.CONCLUSIONAlthough 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.
Author	Neely, Michael N. Wicha, Sebastian G. Alffenaar, Jan-Willem C. Udy, Andrew A. Bassetti, Matteo Sjovall, Fredrik Pea, Federico Zeitlinger, Markus Paiva, Jose-Artur Bracht, Hendrik Abdul-Aziz, Mohd H. De Waele, Jan J. Marriott, Deborah Timsit, Jean F. Dimopoulos, George Roberts, Jason A.
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BackLink	https://www.ncbi.nlm.nih.gov/pubmed/32383061$$D View this record in MEDLINE/PubMed
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Snippet	This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in... PurposeThis Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in...
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SubjectTerms	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
Title	Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper
URI	https://www.ncbi.nlm.nih.gov/pubmed/32383061 https://www.proquest.com/docview/2412413160 https://www.proquest.com/docview/3191380998 https://www.proquest.com/docview/2400545212 https://pubmed.ncbi.nlm.nih.gov/PMC7223855
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