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Antibiotic Therapy in Sepsis: No Next Time for a Second Chance! Publisher Pubmed



Shahrami B1 ; Sharif M1 ; Sefidani Forough A2 ; Najmeddin F1 ; Arabzadeh AA3 ; Mojtahedzadeh M1
Authors
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Authors Affiliations
  1. 1. Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. School of Clinical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
  3. 3. Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran

Source: Journal of Clinical Pharmacy and Therapeutics Published:2021


Abstract

What is known and objective: Sepsis is a life-threatening organ dysfunction associated with a high rate of morbidity and mortality. Appropriate antibiotic therapy remains the cornerstone of sepsis and septic shock management. Comment: Although the early initiation of antimicrobial agents in the treatment of sepsis is widely acknowledged, the selection and adjustment to optimal dosage can be equally important. Since significant pathophysiological changes in the critically ill patients lead to altered pharmacokinetics of antibiotics, early consideration of pharmacokinetic/pharmacodynamic (PK/PD) properties is necessary for optimal antibiotic dosing in sepsis and should be integrated in practice. What is new and conclusion: Where possible, an individualized antibiotic dosing approach through the application of therapeutic drug monitoring (TDM) service should replace the conventional dosing in critically ill patients with sepsis. Finally, antimicrobial stewardship can help improve clinical outcomes. © 2021 John Wiley & Sons Ltd
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