Anest. intenziv. Med. 2009;20(1):25-29

Dosage and administration of antibiotics in critically ill patientsIntesive Care Medicine - Review Article

Chytra Ivan^*, Štěpán Martin

Anesteziologicko-resuscitační klinika LF UK a Fakultní nemocnice v Plzni

Early and appropriate antibacterial therapy is a principal intervention in septic patients. Adequate fluid resuscitation in the hyperdynamic stage of sepsis increases renal perfusion and via increased capillary permeability leads to a leak into the third space. The increased clearance and volume of distribution may result in low plasmatic concentration of antimicrobial drugs. Alternatively, sepsis can induce multiple organ dysfunction (kidney, liver), causing a decrease of antimicrobial drug clearance with increased risk of toxic effects.
To optimize antibacterial therapy, clinician must know the properties of the used antibiotics and how these may be affected by the pathophysiological changes occurring during sepsis.

Keywords: antimicrobial therapy; sepsis; pathophysiological changes; pharmacokinetic and pharmacodynamic parameters; dosage of antibiotics

Received: October 21, 2008; Accepted: December 7, 2008; Published: February 1, 2009  Show citation