A Review of Therapeutic Drug Monitoring of Beta-Lactams

AbstractPurpose of ReviewBeta-lactam antibiotics are among the most commonly prescribed drug classes in the hospital setting. The pharmacokinetic/pharmacodynamic index correlated with bactericidal activity of beta-lactam antibiotics is the amount of time drug concentrations exceeds the minimum inhibitory concentration over the course of a dosing interval. Standard dosing is based on preclinical trials conducted in healthy volunteers with considerations for renal function and weight to maintain time over minimum inhibitory concentration for an appropriate percentage of the dosing interval. It is commonly accepted that critically ill patients have altered pharmacokinetics which may impact drug efficacy; however, current dosing strategies do not account for these variances. As such, standard dosing delineated in package inserts may not optimize time over the minimum inhibitory concentration. Therapeutic drug monitoring of beta-lactams has been proposed as a possible method to ensure dose optimization in a state of critical illness. To date, there have been limited clinical studies supporting the routine use of therapeutic drug monitoring of beta-lactams, as well as an uncertainty regarding how the process can be applied in the clinical setting. The purpose of this review is to elucidate the current state of therapeutic drug monitoring of beta-lactams and evaluate clinical outcomes of patients who received therapeutic drug monitoring of beta-lactams compared to the standard of ca...
Source: Current Infectious Disease Reports - Category: Infectious Diseases Source Type: research