Abstract
Severe sepsis and septic shock account for 15–20% of intensive care unit (ICU) admissions and when associated with multi-organ dysfunction there is a 55% mortality [1]. Surgical evacuation of any focus of infection should be undertaken where possible, however, the mainstay of treatment is antibiotic therapy. In recent years there have been considerable advances in the support of these patients with emphasis being placed on early, adequate volume resuscitation [2], administration of stress-dose corticosteroids [3], immunonutrition [4], and, more recently, manipulation of coagulation pathways [5]. However, the way in which antibiotics are administered has remained largely unchanged since the 1940s. At a time when many standard therapies are being re-evaluated we should ask the question ‘Are we using antibiotics to their greatest potential?’
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References
Brun-Buisson C, Doyon F, Carlet J, et al (1995) Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA 274:968–974
Rivers E, Nguyen B, Havstad S, et al (2001) Early goal directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377
Bollaert P-E, Charpentier C, Levy B, et al (1998) Reversal of late septic shock with supra-physiological doses of hydrocortisone. Crit Care Med 26:645–650
Wyncoll D, Beale R (2001) Immunologically enhanced enteral nutrition: current status. Curr Opin Crit Care 7:128–132
Bernard GR, Vincent JL, Laterre PF, et al (2001) Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344:699–709
de Man P, Verhoeven B, Verbrugh H, Vos M, van den Anker J (2000) An antibiotic policy to prevent emergence of resistant bacilli. Lancet 355:973–978
Carbón C (1992) Single-dose antibiotic therapy: what has the past taught us? J Clin Pharmacol 32:686–691
Rotschafer JC, Zabinski RA, Walker KJ, Vance-Bryan K (1992) Pharmacotherapy and pharmacodynamics in the management of bacterial infection. J Clin Pharmacol 32:1083–1088
Drusano GL (1988) Role of pharmacokinetics in the outcome of infections. Antimicrob Agents Chemother 32:289–297
Craig WA (1995) Antibiotic selection factors and description of a hospital-based outpatient antibiotic therapy program in the USA. Eur J Clin Microbiol Infect Dis 14:636–642
MacGowan AP, Bowker KE (1998) Continuous infusion of β-lactam antibiotics. Clin Phar-macokinet 35:391–402
MacGowan AP, Bowker KE (1997) Pharmacodynamics of antimicrobial agents and rationale for their dosing. J Chemotherapy 9:64–73
Young RJ, Lipman J, Gin T, Gomersall CD, Joynt GM, Oh TE (1997) Intermittent bolus dosing of ceftazidime in critically ill patients. J Antimicrob Chemother 40:269–273
Lipman J, Gomersall CD, Gin T, Joynt GM, Young RJ (1999) Continuous infusion ceftazidime in intensive care: a randomised controlled trial. J Antimicrob Chemother 43:309–311
Gould IM (1997) Pharmacodynamics and the relationship between in vitro and in vivo activity of antimicrobial agents. J Chemother 9:73–83
Thalhammer F, Traunmüller F, Menyawi IE, et al (1999) Continuous infusion versus intermittent administration of meropenem in critically ill patients. J Antimicrob Chemother 43:523–527
Massias L, Dubois C, de Lentdecker P, et al (1992) Penetration of vancomycin in uninfected sternal bone. Antimicrob Agents Chemother 36:2539–2541
Cruciani M, Gatti G, Lazzarini L, et al (1996) Penetration of vancomycin into human lung tissue. J Antimicrob Chemother 38:865–869
Georges H, Leroy O, Alfandari S, et al (1997) Pulmonary disposition of vancomycin in critically ill patients. Eur J Clin Microbiol Infect Dis 16:385–388
Ellner PD, Neu HC (1981) The inhibitory quotient. A method for interpreting minimum inhibitory concentration data. JAMA 246:1575–1578
Levine DP, Fromm BS, Reddy BR (1991) Slow response to vancomycin or vancomycin plus rifampin in methicillin-resistant Staphylococcus aureus endocarditis. Ann Intern Med 115:674–680
James JK, Palmer SM, Levine DP, Rybak MJ (1966) Comparison of conventional dosing versus continuous-infusion vancomycin therapy for patients with suspected or documented gram-positive infections. Antimicrob Agents Chemother 40:696–700
Wysocki M, Delatour F, Faurisson F, et al (2001) Continuous versus intermittent infusion of vancomycin in severe Staphylococcal infections: prospective multicenter randomised study. Antimicrob Agents Chemother 45:2460–2467
NcNabb JJ, Nightingale CH, Quintiliani R, Nicolau DP (2001) Cost-effectiveness of ceftazidime by continuous infusion versus intermittent infusion for nosocomial pneumonia. Pharmacotherapy 21:549–555
Saunders NJ (1994) Why monitor peak vancomycin concentrations. Lancet 344:1748–1750
Eagle HR, Fleischman R, Musselman (1950) Effect of schedule of administration on the therapeutic efficacy of penicillin: importance of the aggregate time penicillin remains at effectively bactericidal levels. Am J Med 9:280–299
Servaais H, Tulkens PM (2001) Stability and compatibility of ceftazidime administered by continuous infusion to intensive care patients. Antimicrob Agents Chemother 45:2643–2647
Trissel LA (1998) Handbook on Injectable Drugs, 10th ed. American Society of Health System Pharmacists, Bethesda
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Wyncoll, D.L.A., Bowry, R., Giles, L.J. (2002). Antibiotics by Continuous Infusion: Time for Re-evaluation?. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 2002. Yearbook of Intensive Care and Emergency Medicine 2002, vol 2002. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56011-8_36
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DOI: https://doi.org/10.1007/978-3-642-56011-8_36
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