[Therapeutic Drug Monitoring of antiinfectives in intensive care medicine]

Dtsch Med Wochenschr. 2014 Sep;139(38):1889-94. doi: 10.1055/s-0034-1387215. Epub 2014 Sep 9.
[Article in German]

Abstract

Therapeutic Drug Monitoring (TDM) is based on drug-level control in biological matrices and serves as a diagnostic approach for individualization of pharmacotherapy and drug safety. Drug levels of antibiotics are distinctly influenced by comorbidity, physiological changes and various concomitant drugs in patients on intensive care units. Several factors should be taken into account for calculation of relevant pharmacokinetic parameters (elimination half-life, bioavailability, and clearance) to deduce a recommendation for dosage. TDM is a diagnostic standard for the individualization of polypharmcotherapy based on validated analytical methods (in particular LC-MS/MS and HPLC-methods) in order to optimize dosing and drug safety.

Publication types

  • Comparative Study
  • English Abstract
  • Review

MeSH terms

  • Acetamides / pharmacokinetics
  • Acetamides / therapeutic use
  • Aminoglycosides / pharmacokinetics
  • Aminoglycosides / therapeutic use
  • Anti-Bacterial Agents / pharmacokinetics*
  • Anti-Bacterial Agents / therapeutic use*
  • Biological Availability
  • Dose-Response Relationship, Drug
  • Drug Monitoring*
  • Drug Therapy, Combination
  • Fluoroquinolones / pharmacokinetics
  • Fluoroquinolones / therapeutic use
  • Guideline Adherence
  • Humans
  • Intensive Care Units*
  • Linezolid
  • Metabolic Clearance Rate / physiology
  • Microbial Sensitivity Tests
  • Oxazolidinones / pharmacokinetics
  • Oxazolidinones / therapeutic use
  • Sepsis / blood*
  • Sepsis / drug therapy*
  • Sepsis / mortality
  • Shock, Septic / blood*
  • Shock, Septic / drug therapy*
  • Shock, Septic / mortality
  • Teicoplanin / pharmacokinetics
  • Teicoplanin / therapeutic use
  • Vancomycin / pharmacokinetics
  • Vancomycin / therapeutic use
  • beta-Lactams / pharmacokinetics
  • beta-Lactams / therapeutic use

Substances

  • Acetamides
  • Aminoglycosides
  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Oxazolidinones
  • beta-Lactams
  • Teicoplanin
  • Vancomycin
  • Linezolid