JOURNAL ARTICLE
REVIEW

Advances in antibiotic therapy in the critically ill

Jean-Louis Vincent, Matteo Bassetti, Bruno Fran├žois, George Karam, Jean Chastre, Antoni Torres, Jason A Roberts, Fabio S Taccone, Jordi Rello, Thierry Calandra, Daniel De Backer, Tobias Welte, Massimo Antonelli
Critical Care: the Official Journal of the Critical Care Forum 2016 May 17, 20 (1): 133
27184564
Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation. Antibiotic pharmacodynamics and pharmacokinetics, notably volumes of distribution and clearance, can be altered by critical illness and can influence dosing regimens. Dosing decisions in different subgroups of patients, e.g., the obese, are also covered. We also briefly consider ventilator-associated pneumonia and the role of inhaled antibiotics. Finally, we mention antibiotics that are currently being developed and show promise for the future.

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Ali Asghar

It'd be nice if I could take notes and have them associated with particular articles

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Adel Saleem

Management of resistant klebsiella pneumonia

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