Antimicrobial Stewardship and Optimizing Antibiotic Dose in Critically Ill Patients

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 695

Special Issue Editor


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Guest Editor
Brighton and Sussex Medical School, Brighton BN1 9PX, UK
Interests: critical illness pharmacokinetics and pharmacodynamics; acute kidney injury

Special Issue Information

Dear Colleagues,

The escalating crisis of antibiotic resistance, coupled with a decrease in the development of novel antibiotics, demands innovative approaches to improve current antimicrobial prescribing practices. This Special Issue focuses on antimicrobial stewardship and optimizing antibiotic dose in critically ill patients, highlighting the challenges clinicians face in striking the balance between effective therapy and minimizing antibiotic resistance.

In clinical practice, ensuring appropriate antibiotic dosing is essential for therapeutic success in critically ill patients. Critical illness has profound effects on the pharmacokinetics and pharmacodynamics of antibiotics. Patients are at an increased risk of both under- and overdosing of drugs, leading to either therapeutic failure, antibiotic resistance or toxicity. We suggest that the articles submitted to this Special Issue focus on the importance of individualizing antibiotic therapy, developing dynamic prescribing practices, incorporating clinical susceptibility data and employing pharmacokinetic/pharmacodynamic principles for dose optimization.

Additionally, this issue will cover the antimicrobial stewardship programs (ASPs) that promote responsible antibiotic use. By integrating these programs into the healthcare system, healthcare professionals can align their prescribing practices with evidence-based guidelines and minimize the development of resistant strains. The need for collaboration between different disciplines—such as infection control, microbiology, clinical pharmacy and therapeutics—is underscored throughout this issue to maximize the outcomes of ASPs.

Prof. Dr. Barbara J. Philips
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antibiotics
  • antimicrobials
  • intensive care
  • critical care
  • sepsis
  • pharmacokinetics
  • pharmacodynamics
  • stewardship
  • beta-lactams
  • aminoglycosides
  • quinolones
  • cephalosporins
  • antifungal

Published Papers (1 paper)

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Research

9 pages, 843 KiB  
Article
Dosing Regimen for Cefotaxime Should Be Adapted to the Stage of Renal Dysfunction in Critically Ill Adult Patients—A Retrospective Study
by Théo Dillies, Sophie Perinel-Ragey, Patricia Correia, Jérôme Morel, Guillaume Thiery and Manon Launay
Antibiotics 2024, 13(4), 313; https://doi.org/10.3390/antibiotics13040313 - 29 Mar 2024
Viewed by 553
Abstract
Cefotaxime administration is recommended in doses of 3–12 g/day in adults with a Glomerular Filtration Rate (GFR) > 5 mL/min. This study aimed to assess the impact of renal function and obesity on cefotaxime concentrations in intensive care unit (ICU) patients. A retrospective [...] Read more.
Cefotaxime administration is recommended in doses of 3–12 g/day in adults with a Glomerular Filtration Rate (GFR) > 5 mL/min. This study aimed to assess the impact of renal function and obesity on cefotaxime concentrations in intensive care unit (ICU) patients. A retrospective cohort study was conducted on consecutive ICU patients receiving continuous cefotaxime infusion between 2020 and 2022 [IRBN992021/CHUSTE]. Doses were not constant; consequently, a concentration-to-dose ratio (C/D) was considered. Statistical analysis was performed to assess the relationship between cefotaxime concentrations, renal function, and obesity. A total of 70 patients, median age 61 years, were included, with no significant difference in cefotaxime concentrations between obese and non-obese patients. However, concentrations varied significantly by GFR, with underdosing prevalent in patients with normal to increased renal function and overdosing in those with severely impaired renal function. Adjustment of cefotaxime dosing according to GFR was associated with improved target attainment. Cefotaxime dosing in critically ill patients should consider renal function, with higher initial doses required in patients with normal to increased GFR and lower doses in those with severely impaired renal function. Therapeutic drug monitoring may aid in optimising dosing regimens. Prospective studies are warranted to validate these findings and inform clinical practice. Full article
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