Definitions and implications of the pharmacokinetic-pharmacodynamic parameters of antibiotics in pediatric clinical practice - 02/12/23
Highlights |
• | Integration of the pharmacokinetic and pharmacodynamic (PK/PD) parameters of pharmacokinetics and pharmacodynamics (PK/PD) has often been the cornerstone of antibiotic selection. |
• | Time above minimum inhibitory concentration (MIC) is the main predictive PK/PD parameter for ß-lactams, serum peak to MIC ratio for aminoglycosides, and area under the curve to MIC ratio for macrolides, vancomycin and quinolones. |
• | These parameters are particularly important when managing patients infected with less susceptible bacterial species, those with underlying conditions including immunocompromised patients, and those in intensive care. |
• | In addition, they significantly contribute to optimal determination of unit doses and spacing between administrations. |
Abstract |
Knowledge of infectious diseases and their treatments is constantly evolving. New infectious agents are regularly discovered, mainly due to improvement of identification techniques, especially the development of molecular biology and mass spectrometry. While changes in the epidemiology of infectious diseases are not always predictable or readily understood, several factors regularly enter into consideration, such as not only the natural history of diseases, the impact of vaccinations, but also the excessive and irrational use of antibiotics. Antibiotic resistance is now recognized as one of the major challenges for humanity, especially since few new molecules have been put on the market in recent years. These molecules are reserved for serious infections caused by bacteria resistant to other antibiotics and should only be prescribed by infectious diseases specialists trained in their use. Rationalization of antibiotic therapy is therefore one of the keys to reducing antibiotic resistance and the spread of resistant bacteria.
In this guide, for each clinical situation, the bacterial target(s) of antibiotic treatment, the preferred antibiotic choice, and the therapeutic alternatives will be specified. Comments on the diagnosis and treatment of the infection will be added if necessary.
Le texte complet de cet article est disponible en PDF.Keywords : Antibiotic therapy, Principles, Children
Plan
Vol 53 - N° 8S
Article 104781- novembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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