title: [Pharmacokinetics and pharmacodynamics of antibiotics in intensive care].
abstract: Optimized dosage regimens of antibiotics have remained obscure since their introduction. During the last two decades pharmacokinetic(PK)-pharmacodynamic(PD) relationships, originally established in animal experiments, have been increasingly used in patients. The action of betalactams is believed to be governed by the time the plasma concentration is above the minimum inhibitory concentration (MIC). Aminoglycosides act as planned when the peak concentration is a multiple of the MIC and vancomycin seems to work best when the area under the plasma vs. time curve (AUC) to MIC has a certain ratio. Clinicians should be aware that these relationships can only be an indication in which direction dosing should go. Larger studies with sufficiently high numbers of patients and particularly severely sick patients are needed to prove the concepts. In times where all antibiotics can be measured with new technologies, the introduction of therapeutic drug monitoring (TDM) is suggested for ICUs (Intensive Care Unit). The idea of a central lab for TDM of antibiotics such as PEAK (Paul Ehrlich Antibiotika Konzentrationsmessung) is supported.
authors: IBMP - Institut für Biomedizinische und Pharmazeutische Forschung, Paul-Ehrlich-Straße 19, 90562, Nürnberg-Heroldsberg, Deutschland. ibmp@osn.de.|Institut für Pharmakologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland. ibmp@osn.de.
authors: F
authors: F
authors: Sörgel
authors: Universitätsinstitut für Klinikhygiene, Medizinische Mikrobiologie und klinische Infektiologie, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland.
authors: R
authors: R
authors: Höhl
authors: IBMP - Institut für Biomedizinische und Pharmazeutische Forschung, Paul-Ehrlich-Straße 19, 90562, Nürnberg-Heroldsberg, Deutschland.
authors: R
authors: R
authors: Glaser
authors: IBMP - Institut für Biomedizinische und Pharmazeutische Forschung, Paul-Ehrlich-Straße 19, 90562, Nürnberg-Heroldsberg, Deutschland.
authors: C
authors: C
authors: Stelzer
authors: IBMP - Institut für Biomedizinische und Pharmazeutische Forschung, Paul-Ehrlich-Straße 19, 90562, Nürnberg-Heroldsberg, Deutschland.
authors: M
authors: M
authors: Munz
authors: IBMP - Institut für Biomedizinische und Pharmazeutische Forschung, Paul-Ehrlich-Straße 19, 90562, Nürnberg-Heroldsberg, Deutschland.
authors: M
authors: M
authors: Vormittag
authors: IBMP - Institut für Biomedizinische und Pharmazeutische Forschung, Paul-Ehrlich-Straße 19, 90562, Nürnberg-Heroldsberg, Deutschland.
authors: M
authors: M
authors: Kinzig
authors: Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, USA.
authors: J
authors: J
authors: Bulitta
authors: Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, 3052, Parkville, Victoria, Australia.|School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
authors: C
authors: C
authors: Landersdorfer
authors: Universitätsklinik für Anästhesiologie und operative Intensivmedizin, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland.
authors: A
authors: A
authors: Junger
authors: Universitätsklinik für Notfallmedizin und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland.
authors: M
authors: M
authors: Christ
authors: Universitätsklinik für Onkologie und Hämatologie, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland.
authors: M
authors: M
authors: Wilhelm
authors: Lehrstuhl für Pharmazeutische und Medizinische Chemie, Institut für Pharmazie und Lebensmittelchemie, Julius-Maximilians-Universität Würzburg, Am Hubland, 97074, Würzburg, Deutschland.
authors: U
authors: U
authors: Holzgrabe
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D003422:Critical Care; D016903:Drug Monitoring; D005260:Female; D006207:Half-Life; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D013058:Mass Spectrometry; D008657:Metabolic Clearance Rate / Q000502:physiology; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000493:pharmacokinetics / Q000627:therapeutic use; D011485:Protein Binding / Q000502:physiology; D012016:Reference Values; D014640:Vancomycin / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D014640:Vancomycin
keywords: Antibiotics; Critically ill; Mass spectrometry; Penicillin; Therapeutic drug monitoring