Can personalised antibiotic dosing in ICU improve patient outcomes? What data supports personalised dosing which is more labour-intensive than a "one-dose fits all" approach? If we were to commit to personalised dosing, how can we do this?
The answers to these important questions were offered to attendees of the Annual Congress of the European Society of Intensive Care Medicine (ESICM) by Prof Jeffrey Lipman, during a keynote presentation on October 22, 2018 in Paris, France.
In his talk, Prof Lipman asserted that the prescribers are underdosing most antimicrobials in the ICU context and should consider using higher doses.
Prof Lipman envisioned a paradigm shift whereby antimicrobial dosing will be optimised - and antimicrobial resistance minimised - with the advances witnessed largely as a result of the low-cost-high-impact PK/PD studies resulting in better quality dosing nomograms becoming available, Therapeutic Drug Monitoring (TDM) with adaptive feedback depending on the drug levels measured and the emergence of dosing recommendations embedded in readily accessible at-the-point-of-care apps.
Together with other investigators from the CRE REDUCE, including Dr Claire Roger (Nimes Uni, France), Prof Jordi Rello (Hospital Vall d'Hebron, Barcelona, Spain) and Dr Jan De Waele (Ghent Uni, Belgium), Prof Lipman was also prominent in a one-day workshop preceding the ESICM meeting where he delivered a "master class" in PK/PD principles and communicated the learnings of our research centre.
