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Critical Care
Published in: Critical Care 1/2016

Open Access 01-12-2016 | Review

Advances in antibiotic therapy in the critically ill

Authors: Jean-Louis Vincent, Matteo Bassetti, Bruno François, George Karam, Jean Chastre, Antoni Torres, Jason A. Roberts, Fabio S. Taccone, Jordi Rello, Thierry Calandra, Daniel De Backer, Tobias Welte, Massimo Antonelli

Published in: Critical Care | Issue 1/2016

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Abstract

Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation. Antibiotic pharmacodynamics and pharmacokinetics, notably volumes of distribution and clearance, can be altered by critical illness and can influence dosing regimens. Dosing decisions in different subgroups of patients, e.g., the obese, are also covered. We also briefly consider ventilator-associated pneumonia and the role of inhaled antibiotics. Finally, we mention antibiotics that are currently being developed and show promise for the future.
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Metadata
Title
Advances in antibiotic therapy in the critically ill
Authors
Jean-Louis Vincent
Matteo Bassetti
Bruno François
George Karam
Jean Chastre
Antoni Torres
Jason A. Roberts
Fabio S. Taccone
Jordi Rello
Thierry Calandra
Daniel De Backer
Tobias Welte
Massimo Antonelli
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2016
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-016-1285-6

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