Clinical Pharmacokinetics and Dose Optimization of Anti-infectives in Critical Care
A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Pharmacokinetics and Pharmacodynamics of Drugs".
Deadline for manuscript submissions: closed (15 November 2023) | Viewed by 21687
Special Issue Editors
Interests: individualized dosing & therapeutic drug monitoring, pharmacokinetics/-dynamics of antimicrobials; infections in intensive care (bacterial, viral & fungal); sepsis & septic shock
Special Issue Information
Dear Colleagues,
The scientific work of the last decade has led to a drastic change in both the understanding and the use of anti-infective substances in critically ill patients. A central factor was the realization that pathophysiological changes in the course of intensive care treatment lead to profound alterations in the pharmacokinetic (PK) properties of many anti-infective substances. Accordingly, clinical data have repeatedly demonstrated that standard bolus applications of fixed doses jeopardize treatment success in critically ill patients, most likely due to significant variations in the serum concentrations of the anti-infective drug (while most of these data relate to antibiotics, the latter effects occur in other anti-infective substances, too). These findings made clinicians abandon the “one-size-fits-all” dogma and stressed the need for a pharmacokinetic (PK)/pharmacodynamic (PD)-centered dose optimization of anti-infective drugs. Dose optimization measures encompass a modern administration regimen for appropriate substances (i.e., extended infusions for carbapenems and b-lactams), the use of individually calculated doses with respect to the clinical scenario (sepsis, septic shock) and attention to organ dysfunction (i.e., acute kidney injury, renal replacement therapy). The goals of PK/PD and dose optimization are to assure optimal exposure of pathogens and drugs in any given clinical scenario and to minimize insufficiently low or toxic concentrations at the same time. Therapeutic drug monitoring (TDM) is still routinely utilized to determine (mostly) serum concentrations of the drug and deduct individual doses according to the TDM result. The sole use of TDM for optimized drug dosing harbors the risk of significant variations in serum concentrations, especially after treatment initiation. Given the limitations of TDM (costs, availability, time-to-reporting of results), PK simulations/dose approximation algorithms and the facilitation of artificial intelligence (AI) to determine individual doses a priori are promising tools that might, in fact, reduce the need for continuous TDM measures. A combination of TDM, PK simulations and extended infusion (depending on the substance) might be a promising approach to increase treatment efficacy in the future.
This Special Issue of Antibiotics aims to publish manuscripts that highlight the importance of clinical pharmacokinetics and dose optimization in critically ill patients. We understand that a great share of the topic refers to antibiotic treatment. However, manuscripts discussing PK/PD and dose-optimisation in antifungals or even antivirals are appreciated as well. Since Antibiotics understands itself as being a part of scientific progress, we explicitly encourage a critical discussion of the topic.
Dr. Daniel Richter
Prof. Dr. Thorsten Brenner
Guest Editors
Manuscript Submission Information
Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.
Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.
Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.
Keywords
- pharmacokinetics (PK)
- pharmacodynamics (PD)
- anti-infective drugs
- dose optimization
- therapeutic drug monitoring (TDM)
- dose approximation
- critical care
Benefits of Publishing in a Special Issue
- Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
- Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
- Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
- External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
- e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.
Further information on MDPI's Special Issue polices can be found here.