Drug utilisation in adult, paediatric and neonatal intensive care units, with an emphasis on systemic antimicrobials

Abstract

Intensive care units (ICUs) are the focal points for emergence of multidrug resistant organisms [1]. Factors responsible for triggering the emergence of multidrug resistant organisms in critically ill patients include the following: aged > 65 years, prior antimicrobial therapy, or hospitalisation for ≥ 2 days in the last 3 months, in-home wound care, chronic dialysis within the last month and presence of a family member with a resistant microorganism or ongoing immunosuppressive treatment [2]. Several strategies have been shown to be beneficial in optimising antimicrobial therapy in critically ill patients, such as continuous infusion of beta-lactams and vancomycin and using procalcitonin for tapering and discontinuation of the antimicrobial drugs [3]. Novel strategies such as faecal microbiota transplantation and bacteriophage therapy have also been demon

Current knowledge, challenges and innovations in developmental pharmacology: A combined conect4children Expert Group and European Society for Developmental, Perinatal and Paediatric Pharmacology White Paper

“…In contrast, in an intensive care setting the parenteral (mainly intravenous) route is used in 71.3, 60.7 and 68.7% of drug administrations in adult, paediatric and neonatal intensive care unit patients, respectively. 9 For most drugs, children are sufficiently different from adults to require dosing adaptations. Understanding the fate of a compound in the body is essential to select the optimal dosing strategy for each individual.…”

“…In the outpatient setting, drugs are commonly administered orally. In contrast, in an intensive care setting the parenteral (mainly intravenous) route is used in 71.3, 60.7 and 68.7% of drug administrations in adult, paediatric and neonatal intensive care unit patients, respectively 9 . For most drugs, children are sufficiently different from adults to require dosing adaptations.…”

Gentamicin in Neonates with Hemodynamically Significant Patent Ductus Arteriosus

“…[ 9 ] Gentamicin is one of the most used aminoglycosides in neonatal intensive care unit. [ 10 ] Most often gentamicin is used in our critical care unit as a part of empirical regimen in suspicion of neonatal sepsis. Preterm neonates are at increased risk of neonatal sepsis due to diminished resistance and increased exposure to microorganisms.…”