Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Introduction
- Pharmacokinetics
- Pharmacodynamics
- Drug Interactions
- Therapeutic Drug Monitoring
- Summary
- Introduction
- Pharmacological Principles of Monitoring
- Pharmacological Characteristics of Antibiotics
- Therapeutic Drug Monitoring for Specific Drugs
- Special Circumstances
- Antibiotic Stewardship
- Acknowledgements
- Introduction
- Blood Groups and Cross-Matching
- Safe Transfusion
- Adverse Effects of Transfusion
- Patient Blood Management
- Effective Transfusion in Surgery and Critical Care
- Major Haemorrhage
- Management of Patients Who Do not Accept Transfusion
- Introduction
- Conventional Coagulation Tests
- Point-of-Care Tests
- Fluids
- Inotropes, Vasopressors and Inodilators
- Vasodilators
- Anti-hypertensives
- Introduction
- Aims and Indications for Mechanical Circulatory Support
- Types of Mechanical Circulatory Support
- Implementation and Monitoring of Mechanical Circulatory Support
- Summary and Conclusion
- Initiating Mechanical Ventilation
- Maintenance of Ventilation
- Modes of Ventilation
- Ventilation Considerations
- Special Considerations
- Weaning from Ventilation
- Introduction
- Indications
- Principles and Techniques of RRT
- Nomenclatures for Continuous RRT
- Modalities of RRT
- Timing of RRT Initiation
- Vascular Access
- Dose of RRT
- Fluid Balance and Management
- Anticoagulation
- CRRT Prescription and Monitoring
- Complications of CRRT
- Weaning from RRT
- Conclusion
- Introduction
- How to Provide Nutritional Support
- Refeeding Syndrome
- Protocols
- Summary
- Introduction
- Intracranial Pressure
- Brain Tissue Oxygen Tension
- Jugular Bulb Oximetry
- Cerebral Microdialysis
- Transcranial Doppler Ultrasound
- Continuous Electroencephalography
- 4.1 Principles of Safe Prescription of Drugs and Therapeutics (Including Pharmacokinetics, Pharmacodynamics and Drug Monitoring)
- 4.2 Antibiotic Management and Monitoring
- 4.3 Administration of Blood and Blood Products in Intensive Care
- 4.4 Monitoring Coagulation, Including Thromboelastography
- 4.5 Fluids, Inotropes and Vasopressors, Vasodilators and Anti-hypertensives
- 4.6 Principles of Mechanical Circulatory Support in the Acute Setting
- 4.7 Mechanical Ventilation: Initiation, Maintenance and Weaning
- 4.8 Renal Replacement Therapy in Critical Care
- 4.9 Nutritional Assessment and Support in Intensive Care (Enteral and Parenteral Nutrition)
- 4.10 Neuromonitoring and Cerebral Protection
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
4.2 - Antibiotic Management and Monitoring
from Section 4 - Therapeutic Interventions and Organ Support
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Introduction
- Pharmacokinetics
- Pharmacodynamics
- Drug Interactions
- Therapeutic Drug Monitoring
- Summary
- Introduction
- Pharmacological Principles of Monitoring
- Pharmacological Characteristics of Antibiotics
- Therapeutic Drug Monitoring for Specific Drugs
- Special Circumstances
- Antibiotic Stewardship
- Acknowledgements
- Introduction
- Blood Groups and Cross-Matching
- Safe Transfusion
- Adverse Effects of Transfusion
- Patient Blood Management
- Effective Transfusion in Surgery and Critical Care
- Major Haemorrhage
- Management of Patients Who Do not Accept Transfusion
- Introduction
- Conventional Coagulation Tests
- Point-of-Care Tests
- Fluids
- Inotropes, Vasopressors and Inodilators
- Vasodilators
- Anti-hypertensives
- Introduction
- Aims and Indications for Mechanical Circulatory Support
- Types of Mechanical Circulatory Support
- Implementation and Monitoring of Mechanical Circulatory Support
- Summary and Conclusion
- Initiating Mechanical Ventilation
- Maintenance of Ventilation
- Modes of Ventilation
- Ventilation Considerations
- Special Considerations
- Weaning from Ventilation
- Introduction
- Indications
- Principles and Techniques of RRT
- Nomenclatures for Continuous RRT
- Modalities of RRT
- Timing of RRT Initiation
- Vascular Access
- Dose of RRT
- Fluid Balance and Management
- Anticoagulation
- CRRT Prescription and Monitoring
- Complications of CRRT
- Weaning from RRT
- Conclusion
- Introduction
- How to Provide Nutritional Support
- Refeeding Syndrome
- Protocols
- Summary
- Introduction
- Intracranial Pressure
- Brain Tissue Oxygen Tension
- Jugular Bulb Oximetry
- Cerebral Microdialysis
- Transcranial Doppler Ultrasound
- Continuous Electroencephalography
- 4.1 Principles of Safe Prescription of Drugs and Therapeutics (Including Pharmacokinetics, Pharmacodynamics and Drug Monitoring)
- 4.2 Antibiotic Management and Monitoring
- 4.3 Administration of Blood and Blood Products in Intensive Care
- 4.4 Monitoring Coagulation, Including Thromboelastography
- 4.5 Fluids, Inotropes and Vasopressors, Vasodilators and Anti-hypertensives
- 4.6 Principles of Mechanical Circulatory Support in the Acute Setting
- 4.7 Mechanical Ventilation: Initiation, Maintenance and Weaning
- 4.8 Renal Replacement Therapy in Critical Care
- 4.9 Nutritional Assessment and Support in Intensive Care (Enteral and Parenteral Nutrition)
- 4.10 Neuromonitoring and Cerebral Protection
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Poor anti-microbial stewardship and selection pressure encourage antibiotic resistance.
2. Pharmacokinetics may be altered significantly and unpredictably by critical illness.
3. Optimal dosing of antibiotics is difficult. Many patients are likely under-dosed.
4. Different antibiotics require different approaches to achieving optimal antibiotic exposure.
5. Therapeutic drug monitoring is standard for aminoglycosides and glycopeptides, but may be helpful for β-lactams, linezolid and some ‘azole’ anti-fungal agents.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 461 - 466Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Abdul-Aziz, M, Lipman, J, Mouton, J, Hope, W, Roberts, J. Applying pharmacokinetic/pharmacodynamic principles in critically ill patients: optimizing efficacy and reducing resistance development. Semin Respir Crit Care Med 2015;36:136–53.CrossRefGoogle ScholarPubMed
Cotta, MO, Roberts, JA, Lipman, J. Antibiotic dose optimization in critically ill patients. Med Intensiva 2015;39:563–72.CrossRefGoogle ScholarPubMed
Johnson, I, Banks, V. Antibiotic stewardship in critical care. BJA Education 2017;17:111–16.CrossRefGoogle Scholar
National Institute for Health and Care Excellence. 2015. Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. www.nice.org.uk/guidance/ng15/chapter/1-RecommendationsGoogle Scholar
Vincent, J-L, Bassetti, M, François, B, et al. Advances in antibiotic therapy in the critically ill. Crit Care 2016;20:133.CrossRefGoogle ScholarPubMed