Važnost razumijevanja farmakokinetičko-farmakodinamičkih odnosa antibiotika u individualiziranom pristupu liječenju pneumonije kod mehanički ventiliranih bolesnika

professional thesis

• Author: Sanja Stepan
• Mentor: Bruno Baršić (mentor)
• Committee member: Petra Turčić (predsjednik povjerenstva)
• Committee member: Bruno Baršić (član povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2023-11-29, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Cilj istraživanja: Cilj je ovoga rada prikazati važnost razumijevanja i poznavanja farmakokinetičko-farmakodinamičkih odnosa antibiotika u individualiziranom doziranju lijeka i postizanju učinkovitog liječenja pneumonije kod mehanički ventiliranih bolesnika.
Materijali i metode: Napravljen je sustavni i retrospektivni pregled stručne i znanstvene literature. Pretražene su trenutno važeće smjernice, publikacije stručnih institucija, terapijski priručnici te drugi raspoloživi izvori relevantni za temu rada. Ključne riječi za pretraživanje baza podataka (Medline/Pubmed, Cochraine, ScienceDirect i Up to date) uključivale su sljedeće pojmove: engl. antibiotics, dosage, pharmacokinetic-pharmacodynamic relationships, ventilator-associated pneumonia – etiology, pathogenesis, clinical manifestations, patient characteristics, pharmacotherapy.
Rezultati: U radu je sistematično prikazana pneumonija kod mehanički ventiliranih bolesnika, uključujući etiologiju, patogenezu, kliničku sliku, prognozu i farmakoterapiju bolesti. Prisutnost uzročnika sa smanjenom osjetljivošću i patofiziološke promjene u organizmu mehanički ventiliranih bolesnika utječu na farmakokinetiku antibiotika i povećavaju rizik od suboptimalnog doziranja lijeka. Suboptimalno doziranje smanjuje vjerojatnost postizanja farmakokinetičko-farmakodinamičkih odnosa antibiotika potrebnih za postizanje učinkovite koncentracije lijeka na mjestu infekcije i povezano je s lošim terapijskim ishodom. Individualizacijom doziranja mogu se postići optimalne koncentracije antibiotika u intervalu doziranja kako bi se osigurala učinkovita terapija i smanjio rizik od pojave toksičnosti i razvoja antimikrobne rezistencije.
Zaključak: Odabir antibiotika i doziranje potrebno je individualizirati za svakog bolesnika u skladu s njegovim specifičnim karakteristikama, a poznavanje povezanosti ishoda liječenja s farmakokinetičko-farmakodinamičkim odnosima lijeka može koristiti u osiguravanju optimalne terapije.

Abstract (english)

Objectives: The aim of this paper is to show the importance of understanding and knowing the pharmacokinetic-pharmacodynamic relationships of antibiotics in individualized drug dosing and achieving effective treatment of Ventilator-associated pneumonia.
Subjects and methods: A systematic and retrospective review of professional and scientific literature was made. Currently valid guidelines, professional institutions publications, therapeutic manuals and other available sources relevant to the topic of the work were searched. Keywords for searching the databases (Medline/Pubmed, Cochraine, ScienceDirect and Up to date) included the following terms: antibiotics, dosage, pharmacokinetic-pharmacodynamic relationships, ventilator-associated pneumonia – etiology, pathogenesis, clinical manifestations, patient characteristics, pharmacotherapy.
Results: The paper systematically presents ventilator-assosiated pneumonia, including etiology, pathogenesis, clinical manifestations, prognosis and pharmacotherapy of the disease. The presence of pathogens with reduced sensitivity and physiological changes in the organism of mechanically ventilated patients affect the pharmacokinetics of antibiotics and increase the risk of suboptimal drug dosing. Suboptimal dosing reduces the likelihood of achieving the pharmacokinetic-pharmacodynamic relationships of antibiotics necessary to achieve effective drug concentrations at the site of infection and is associated with poor therapeutic outcomes. By individualizing the dosage, optimal antibiotic concentrations can be achieved in the dosing interval to ensure effective therapy and reduce the risk of toxicity and the development of antimicrobial resistance.
Conclusion: The choice of antibiotics and dosing must be individualized for each patient in accordance with his specific characteristics, and knowledge of the relations between treatment outcomes and the pharmacokinetic-pharmacodynamic relationship of the drug in ensuring optimal therapy.

• Keywords: antibiotici; doziranje; farmakokinetičko-farmakodinamski odnosi; pneumonija; farmakoterapija
• Keywords (english): antibiotics; dosage; pharmacokinetic-pharmacodynamic relationships; pneumonia; pharmacotherapy
• Language: croatian
• URN:NBN: urn:nbn:hr:163:094912
• Study programme: Title: Clinical pharmacy; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/sveučilišna magistra kliničke farmacije (sveučilišni/a magistar/sveučilišna magistra kliničke farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-07 12:46:48