Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Bench-to-bedside review: Appropriate antibiotic therapy in severe sepsis and septic shock - does the dose matter? | Available online http content 13 3 214 Review Bench-to-bedside review Appropriate antibiotic therapy in severe sepsis and septic shock - does the dose matter Federico Pea1 and Pierluigi Viale2 11nstitute of Clinical Pharmacology Toxicology Department of Experimental and Clinical Pathology and Medicine Medical School University of Udine 33100 Udine Italy 2Clinic of Infectious Diseases Department of Medical and Morphological Research Medical School University of Udine 33100 Udine Italy Corresponding author Federico Pea Published 10 June 2009 This article is online at http content 13 3 214 2009 BioMed Central Ltd Critical Care 2009 13 214 doi cc7774 Abstract Appropriate antibiotic therapy in patients with severe sepsis and septic shock should mean prompt achievement and maintenance of optimal exposure at the infection site with broad-spectrum antimicrobial agents administered in a timely manner. Once the causative pathogens have been identified and tested for in vitro susceptibility subsequent de-escalation of antimicrobial therapy should be applied whenever feasible. The goal of appropriate antibiotic therapy must be pursued resolutely and with continuity in view of the ongoing explosion of antibiotic-resistant infections that plague the intensive care unit setting and of the continued decrease in new antibiotics emerging. This article provides some principles for the correct handling of antimicrobial dosing regimens in patients with severe sepsis and septic shock in whom various pathophysiological conditions may significantly alter the pharmacokinetic behaviour of drugs. Introduction During the last half decade of the 20th century several major studies conducted in critically ill patients in both Europe and the USA demonstrated unequivocally that initial inappropriate antimicrobial treatment for pneumonia was associated with increased mortality 1 . It is of note that both in these earlier studies and in
