title: Antibacterial dosage in intensive-care-unit patients based on pharmacokinetic/pharmacodynamic principles.
abstract: OBJECTIVE
  Selection of the best antibiotic dosage regimen in intensive-care-unit patients is a critical factor for decreasing morbidity and mortality rates. The integration of pharmacokinetics and pharmacodynamics is essential to establishing an adequate therapy. Many studies on this issue have been published in recent years due to its relevance, some of which are commented upon in this review.
  
  
  RESULTS
  Several studies have shown that it is feasible to theoretically forecast pharmacodynamic outcomes and select the most adequate antibiotic therapy with Monte Carlo simulations. Moreover, new strategies such as the use of continuous or extended intravenous beta-lactam infusions may considerably improve therapeutic efficacy.
  
  
  CONCLUSIONS
  Future studies are needed in patients to assess the influence of selecting antibiotic therapy based on the impact of pharmacokinetic/pharmacodynamic on mortality, morbidity, cost, etc. It would be of special interest to evaluate this impact on patients with infections caused by multiresistant pathogens, whose mortality rates are even higher. Moreover, although studies such as this would not be easy, mainly due to the large number of patients required to obtain statistically significant results, they should be strongly encouraged because of the possible clinical and economic benefits.
authors.affiliation: Pharmacy Service (UASP), Hospital Clinic Barcelona, IDIBAPS, Universitat de Barcelona, Spain. dsoy@clinic.ub.es
authors.forename: Dolors
authors.initials: D
authors.lastname: Soy
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001424:Bacterial Infections / Q000188:drug therapy*; D016638:Critical Illness / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D009010:Monte Carlo Method
chemical_list: D000890:Anti-Infective Agents