Sepsis is associated with marked mortality, which may be reduced by prompt initiation of adequate, appropriate doses of antibiotic. Critically ill patients often have physiological changes that reduce blood and tissue concentrations of antibiotic and high rates of multidrug-resistant pathogens, which may affect patients’ outcomes. All critical care professionals, including critical care nurses, should understand antibiotic pharmacokinetics and pharmacodynamics to ensure sound antibiotic dosing and administration strategies for optimal microbial killing and patients’ outcomes. Effective pathogen eradication occurs when the dose of antibiotic reaches or maintains optimal concentrations relative to the minimum inhibitory concentration for the pathogen. Time-dependent antibiotics, such as β-lactams, can be given as extended or continuous infusions. Concentration-dependent antibiotics such as aminoglycosides are optimized by using high, once-daily dosing strategies with serum concentration monitoring. Vancomycin and fluoroquinolones are dependent on both time and concentration above the minimum inhibitory concentration.
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1 April 2016
ARTICLE|
April 01 2016
Application of Antibiotic Pharmacodynamics and Dosing Principles in Patients With Sepsis
Molly E. Droege, PharmD, BCPS;
Molly E. Droege, PharmD, BCPS
Molly E. Droege is a clinical pharmacy specialist, trauma, surgery, orthopedics, UC Health–University of Cincinnati Medical Center, and an assistant professor of clinical pharmacy and an adjunct instructor of advanced clinical nursing University of Cincinnati, Cincinnati, Ohio.
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Suzanne L. Van Fleet, PharmD;
Suzanne L. Van Fleet, PharmD
Suzanne L. Van Fleet is a clinical pharmacy specialist, critical care, UC Health–West Chester Hospital, West Chester, Ohio, and an assistant professor of clinical pharmacy and an adjunct instructor of advanced clinical nursing, University of Cincinnati.
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Eric W. Mueller, PharmD
Eric W. Mueller is an assistant director, clinical services and research, and a clinical pharmacy specialist, critical care, Department of Pharmacy Services, UC Health–University of Cincinnati Medical Center. He is also an adjunct associate professor of pharmacy practice and an adjunct instructor of advanced clinical nursing, University of Cincinnati.
Corresponding author: Eric W. Mueller, pharmd, fccm, fccp, 234 Goodman St, Mail Location 0791, Cincinnati, OH 45291 (e-mail: eric.mueller@uchealth.com).
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Crit Care Nurse (2016) 36 (2): 22–32.
Citation
Molly E. Droege, Suzanne L. Van Fleet, Eric W. Mueller; Application of Antibiotic Pharmacodynamics and Dosing Principles in Patients With Sepsis. Crit Care Nurse 1 April 2016; 36 (2): 22–32. doi: https://doi.org/10.4037/ccn2016881
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