Antimicrobial Pharmacokinetics/dynamics Bedside ... - SWAB

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The jury is still out on continuous infusion of beta-lactam antibiotics in critically ill patientsAdvantagesDisadvantagesLower drug acquisitioncostsReduction of work loadTDM more easyAdequate drug levels later(loading dose)Stability of the antibioticHigh MIC, all drug levelssubtherapeuticA well-designed large prospective study on potential advantages of continuousadministation of beta-lacta antibitics in ICU patients is warrantedVan Zanten ARH. Crit Care Med 2009; 37:2137-2138
Total costs of intravenous antibiotic administrationusing different methods of administrationProcedureVolumetricpumpTimerequired(SD) (min:s)Hourlywages(€)Time costs(€)Materialscosts (€)Total costs(€)5:04 (2:29) 21.90 01.85 02.06 03.91Syringe pump 4:56 (2:03) 21.58 01.78 01.45 03.23Bolus injection 9:21 (2:16) 74.09 11.59 00.10 11.69PiggybackinfusionInsertion of IVcatheterRemoval of IVcatheter5:51 (3:33) 19.75 01.93 03.47 05.4010:15 (6:31) 23.51 04.02 04.30 08.3202:22 (0:36) 19.41 00.74 01.00 01.74Importance of nondrug costs of intravenous antibiotictherapy.Arthur RH van Zanten, et al Critical Care 2003, 7:R184-R190 (DOI 10.1186/cc2388)
Page 1 and 2: Antimicrobial Pharmacokinetics/dyna
Page 3 and 4: Inappropriate therapy and VAP morta
Page 5 and 6: Antibiotic dosing strategies in ren
Page 7 and 8: SepsisIncreased CardiacOutputLeaky
Page 9 and 10: Continuous Renal Replacement Therap
Page 11 and 12: Basic principlesExtracorporeal clea
Page 13 and 14: Efficacy and PharmacodynamicsDrug l
Page 15 and 16: Use of ciprofloxacin in the critica
Page 17 and 18: Quinolones: AUC/MIC > 125AUC above
Page 19 and 20: AUC 1-241ciprofloxacin 2 x 400 mg I
Page 21 and 22: Simulated fractional attainment of
Page 23 and 24: β-lactam static effects: streptoco
Page 25 and 26: More antibiotic specific: T > MIC f
Page 27 and 28: Randomised, prospective, open singl
Page 29: Systematic review on clinical benef
Page 33 and 34: The jury is still out on continuous
Page 35 and 36: Pk during CVVH various antibiotics3
Page 37 and 38: Risk of underdosingHydrophylic anti
Page 39: Thank you!Arthur van Zantenzantena@

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