Abstract
The judicious use of existing antibiotics is vital for preservation their activity against infections. In the time of multidrug resistant pathogens is this approach especially important in the clinical fields characterized by high antibiotic use, such as the intensive care.
Optimization of antibiotic therapy in critically ill patients requires not only good knowledge of pathophysiological changes in severe infections, sepsis or septic shock, but also basic understanding of pharmacokinetic and pharmacodynamic (PK/PD) characteristics of applied antibiotics. Extreme changes of organ functions from hyperdynamic states to the development of multiple organ dysfunction syndrome (MODS), require permanent vigilance in indication, examination and in adjustment of antibiotic dosing regimen in the critically ill.
Invasive therapy procedures such as continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO) are more frequently used in critically ill patients and can have an impact upon antibiotic exposure. In this setting we put the emphasis on the use therapeutic drug monitoring and individual adjustment of dosing regimen.