open access

Vol 47, No 5 (2015)
Review articles
Published online: 2015-10-08
Submitted: 2015-08-11
Accepted: 2015-09-30
Get Citation

Right dose, right now: using big data to optimize antibiotic dosing in the critically ill

Paul W.G. Elbers, Armand Girbes, Manu LNG Malbrain, Rob Bosman
DOI: 10.5603/AIT.a2015.0061
·
Anaesthesiol Intensive Ther 2015;47(5):457-463.

open access

Vol 47, No 5 (2015)
Review articles
Published online: 2015-10-08
Submitted: 2015-08-11
Accepted: 2015-09-30

Abstract

Antibiotics save lives and are essential for the practice of intensive care medicine. Adequate antibiotic treatment is closely related to outcome. However this is challenging in the critically ill, as their pharmacokinetic profile is markedly altered. Therefore, it is surprising that critical care physicians continue to rely on standard dosing regimens for every patient, regardless of the actual clinical situation. This review outlines the pharmacokinetic and pharmacodynamic principles that underlie the need for individualized and personalized drug dosing. At present, therapeutic drug monitoring may be of help, but has major disadvantages, remains unavailable for most antibiotics and has produced mixed results. We therefore propose the AutoKinetics concept, taking decision support for antibiotic dosing back to the bedside. By direct interaction with electronic patient records, this opens the way for the use of big data for providing the right dose at the right time in each patient.

Abstract

Antibiotics save lives and are essential for the practice of intensive care medicine. Adequate antibiotic treatment is closely related to outcome. However this is challenging in the critically ill, as their pharmacokinetic profile is markedly altered. Therefore, it is surprising that critical care physicians continue to rely on standard dosing regimens for every patient, regardless of the actual clinical situation. This review outlines the pharmacokinetic and pharmacodynamic principles that underlie the need for individualized and personalized drug dosing. At present, therapeutic drug monitoring may be of help, but has major disadvantages, remains unavailable for most antibiotics and has produced mixed results. We therefore propose the AutoKinetics concept, taking decision support for antibiotic dosing back to the bedside. By direct interaction with electronic patient records, this opens the way for the use of big data for providing the right dose at the right time in each patient.

Get Citation

Keywords

autokinetics, pharmacokinetics, antibiotics, electronic patient record, decision support, intensive care, critical care

About this article
Title

Right dose, right now: using big data to optimize antibiotic dosing in the critically ill

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47, No 5 (2015)

Pages

457-463

Published online

2015-10-08

DOI

10.5603/AIT.a2015.0061

Bibliographic record

Anaesthesiol Intensive Ther 2015;47(5):457-463.

Keywords

autokinetics
pharmacokinetics
antibiotics
electronic patient record
decision support
intensive care
critical care

Authors

Paul W.G. Elbers
Armand Girbes
Manu LNG Malbrain
Rob Bosman

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