How to Treat Sepsis in the Background of Resistance?: Role of Pharmacodynamics / Pharmacokinetics in Treating Sepsis
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Though a decline has been seen in child mortality and morbidity over the last decades, sepsis in neonates and infants remains a major cause of death. Optimal use of antibiotics in sepsis management is a key factor which can further reduce the number of poor clinical outcomes. Selecting the right antibiotic to which the offending bacteria is susceptible and administrating the antibiotic within the first hour can save many lives. However, the pharmacokinetic profile of an antibiotic is affected by developmental changes such as capacity of drug metabolizing enzymes and maturation of organ function. This can affect antibiotic exposure and response in neonates and infants. While suspecting sepsis, the primary focus of empiric treatment during the initial phase is to assure efficacy and it must be broad based to cover all suspected pathogens. Once the bacterial etiology is confirmed as a cause of sepsis and the in vitro antibiotic susceptibility is established, targeted treatment can be started which ensures optimal balance between efficacy and safety.
KeywordsConcentration dependent killing Minimum inhibitory concentration Pediatric sepsis Pharmacodynamic Pharmacokinetic Time dependent killing
Both the authors have contributed equally for the manuscript. AR is the guarantor for this paper.
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- 7.Craig WA. Postantibiotic effects and the dosing of macrolides, azalides, and streptogramins. In: Zinner SH, Young LS, Acar JF, Neu HC, editors. Expanding Indications for the New Macrolides, Azalides, and Streptogramins. New York: Marcel Dekker; 1997. p. 27–38.Google Scholar
- 16.Pai VB, Nahata MC. Dosing in pediatric patients. In: Murphy JE, editor. Clinical Pharmacokinetics, 6th ed. Bethesda: American Society of Health-System Pharmacists; 2017. p. 65–76.Google Scholar
- 21.Vinita BP, Nahata MC. Drug dosing in pediatric patients. In: Murphy JE, editor. Clinical Pharmacokinetics, 5th ed. Bethesda: American Society of Health-System Pharmacists; 2012.Google Scholar
- 23.van Donge T, Pfister M, Bielicki J, et al. Quantitative analysis of gentamicin exposure in neonates and infants calls into question its current dosing recommendations. Antimicrob Agents Chemother. 2018;62:02004–17.Google Scholar