• Curr Opin Crit Care · Oct 2024

    Review

    Antibiotic dose optimisation in the critically ill: targets, evidence and future strategies.

    • Christopher J Dyer, Jan J De Waele, and Jason A Roberts.
    • Herston Institute of Infectious Diseases (HeIDI), Metro North Health.
    • Curr Opin Crit Care. 2024 Oct 1; 30 (5): 439447439-447.

    Purpose Of ReviewTo highlight the recent evidence for antibiotic pharmacokinetics and pharmacodynamics (PK/PD) in enhancing patient outcomes in sepsis and septic shock. We also summarise the limitations of available data and describe future directions for research to support translation of antibiotic dose optimisation to the clinical setting.Recent FindingsSepsis and septic shock are associated with poor outcomes and require antibiotic dose optimisation, mostly due to significantly altered pharmacokinetics. Many studies, including some randomised controlled trials have been conducted to measure the clinical outcome effects of antibiotic dose optimisation interventions including use of therapeutic drug monitoring. Current data support antibiotic dose optimisation for the critically ill. Further investigation is required to evolve more timely and robust precision antibiotic dose optimisation approaches, and to clearly quantify whether any clinical and health-economic benefits support expanded use of this treatment intervention.SummaryAntibiotic dose optimisation appears to improve outcomes in critically ill patients with sepsis and septic shock, however further research is required to quantify the level of benefit and develop a stronger knowledge of the role of new technologies to facilitate optimised dosing.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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