Improving pharmacokinetic/pharmacodynamic outcomes of antimicrobial therapy for pneumonia in the ICU

Expert Opin Pharmacother. 2024 Nov 25. doi: 10.1080/14656566.2024.2432478. Online ahead of print.

Abstract

Introduction: Pneumonia remains a significant global health challenge due to its high prevalence and mortality rate, and challenging treatment. This review explores the best strategies to optimize the antibiotic therapy for pneumonia in critically ill patients, focusing on pharmacokinetics, pharmacodynamics, and therapeutic data.

Areas covered: A review of scientific publications on severe pneumonia highlights the challenges of optimizing antibiotic use to improve lung diffusion, bacterial killing, and achieving PK/PD targets, emphasizing the need to understand microbiological epidemiology and MIC breakpoints. Key strategies like nebulization, therapeutic drug monitoring, and emerging technologies such as ELF TDM and nanomaterial-based drug delivery systems are essential for optimizing PK/PD outcomes and addressing antimicrobial resistance.

Expert opinion: Improving our understanding of pulmonary pharmacokinetics and optimizing their tissue diffusion are instrumental for achieving precision antibiotic therapy for severe pneumonia. By addressing current limitations and embracing interdisciplinary collaboration, we can pave the way for more efficient personalized approaches in infectious diseases management.

Keywords: Pharmacokinetics/Pharmacodynamics; Sepsis; antibiotics; critically ill; lung diffusion; multi-drug resistant organisms; pneumonia.