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Crit Care. 2009;13(3):214. doi: 10.1186/cc7774. Epub 2009 Jun 10.

Bench-to-bedside review: Appropriate antibiotic therapy in severe sepsis and septic shock--does the dose matter?

Author information

1
Department of Experimental and Clinical Pathology, Institute of Clinical Pharmacology & Toxicology, Medical School, University of Udine, 33100 Udine, Italy. pea.federico@aoud.sanita.fvg.it

Abstract

Appropriate antibiotic therapy in patients with severe sepsis and septic shock should mean prompt achievement and maintenance of optimal exposure at the infection site with broad-spectrum antimicrobial agents administered in a timely manner. Once the causative pathogens have been identified and tested for in vitro susceptibility, subsequent de-escalation of antimicrobial therapy should be applied whenever feasible. The goal of appropriate antibiotic therapy must be pursued resolutely and with continuity, in view of the ongoing explosion of antibiotic-resistant infections that plague the intensive care unit setting and of the continued decrease in new antibiotics emerging. This article provides some principles for the correct handling of antimicrobial dosing regimens in patients with severe sepsis and septic shock, in whom various pathophysiological conditions may significantly alter the pharmacokinetic behaviour of drugs.

PMID:
19519961
PMCID:
PMC2717408
DOI:
10.1186/cc7774
[Indexed for MEDLINE]
Free PMC Article

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