Can we transfer pharmacokinetics/pharmacodynamics of antimicrobials into clinical practice?

Abstract

In critically ill patients there is extensive evidence of subtherapeutic antibiotic exposure from standard doses across different antibiotic classes. This can be a direct consequence of pharmacokinetic alterations emanating from the complex pathophysiological processes associated with severe infection. Therapeutic drug monitoring (TDM) is being increasingly used for antibiotic dose optimisation in an attempt to improve the attainment of pharmacokinetic/pharmacodynamic (PK/PD) targets and the outcomes of severe infection in critically ill patients. In clinical practice, it is necessary to reduce the number of blood samples collected from the patient to a minimum because of the cost (personnel, devises and analysis). TDM to calculate PK/PD indices is easily feasible only when a single blood sample is adequate to perform the analysis.