Appropriate Antimicrobial Therapy in Critically Ill Patients

摘要: Appropriate antibiotic therapy in the critically ill requires more specialised considerations than just selecting most suitable and adhering to traditional dosing guidelines. Unfortunately, of guideline recommendations are based on research that either underrepresent or exclude patients. The pathophysiology critical illness, as case intraabdominal sepsis, has many unique features unseen noncritically These include inconsistent changes important physiological phenomena govern drug disposition. It follows disposition several antimicrobials is markedly different variable relative described by development clinical trials often conducted healthy volunteers Drug determines how much a dose administer; thus altered simply means required for patients ensure optimal effects likely be different. Indeed studies have illustrated standard doses such beta-lactam antibiotics, vancomycin, aminoglycosides, fluoroquinolones fluconazole largely inadequate due high variability Therefore, regimens should tailored requirements individual This chapter presents discussion current understandings special appropriate with sepsis.