Application of Antibiotic Pharmacodynamics and Dosing Principles in Patients With Sepsis

Activity Summary

Sepsis is associated with marked mortality, which may be reduced by prompt initiation of adequate, appropriate doses of antibiotic. Critically ill patients often have physiological changes that reduce blood and tissue concentrations of antibiotic and high rates of multidrug-resistant pathogens, which may affect patients’ outcomes. All critical care professionals, including critical care nurses, should understand antibiotic pharmacokinetics and pharmacodynamics to ensure sound antibiotic dosing and administration strategies for optimal microbial killing and patients’ outcomes. Effective pathogen eradication occurs when the dose of antibiotic reaches or maintains optimal concentrations relative to the minimum inhibitory concentration for the pathogen. Time-dependent antibiotics, such as β-lactams, can be given as extended or continuous infusions. Concentration-dependent antibiotics such as aminoglycosides are optimized by using high, once-daily dosing strategies with serum concentration monitoring. Vancomycin and fluoroquinolones are dependent on both time and concentration above the minimum inhibitory concentration.

Objectives

Discuss the effects of critical illness on pharmacokinetic and pharmacodynamic parameters of commonly used antibiotics
Describe the rationale for different dosing strategies for antibiotics used in adult critically ill patients
Understand clinical and practical implications of optimizing antibiotic dosage and administration strategies in critically ill patients

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.

Disclosure

This activity has been reviewed by the Nurse Planner. It has been determined that the material presented here shows no bias. Approval of a continuing education activity does not imply endorsement by AACN or ANCC of any commercial products displayed or discussed in conjunction with the activity.

Accreditation

The American Association of Critical-Care Nurses (AACN) is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC's) Commission on Accreditation, ANCC Provider Number 0012 (60 min contact hour). AACN has been approved as a provider of continuing education in nursing by the California State Board of Registered Nursing, California Provider number CEP1036 contact hours (50 min contact hour).

AACN programming meets the standards for most states that require mandatory continuing education contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.