Vnitr Lek 2024, 70(5):303-307 | DOI: 10.36290/vnl.2024.060

Specifics of antibiotic treatment in intensive care

Hynek Bartoš
Klinika infekčních nemocí 3. LF UK a FN Bulovka, Praha

Antibiotics are one of the most frequently administered groups of drugs in intensive care. The treatment of critically ill patients with community and nosocomial infections has some significant specifics compared to the treatment of outpatients or patients hospitalized in wards. Septic patients must be treated in a timely manner with an appropriately chosen empiric antibiotic treatment in a sufficient dose and at adequately selected dosing intervals. Compared to less serious conditions, these patients cannot wait to start antibiotic therapy. Pharmacokinetics is very often changed in critically ill patients, and it also changes dynamically during the course of the disease, so it is advantageous to be able to monitor the levels of antibiotics in the blood and adjust their dosage accordingly. The chosen therapy should be reevaluated daily and possibly adjusted based on valid microbiological results. Appropriately chosen de-escalation is the right principle even for critically ill patients in intensive care units. The article will touch on all the mentioned aspects and try to outline the principles of optimally guided antibiotic therapy in intensive care settings, supported by the current knowledge of evidence-based medicine.

Keywords: antibiotics, ICU, pharmacokinetics, sepsis, septic shock, de-escalation, stewardship.

Accepted: August 28, 2024; Published: September 4, 2024  Show citation

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Bartoš H. Specifics of antibiotic treatment in intensive care. Vnitr Lek. 2024;70(5):303-307. doi: 10.36290/vnl.2024.060.
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