#Loading dose free#

#Loading dose free#

6 Of the three pharmacodynamic parameters described with antimicrobials, optimal efficacy with beta-lactams is achieved when free drug concentrations stay above the minimum inhibitory concentration (MIC) for an extended duration of the recommended dosing interval ( FIGURE 1). 4 Despite the rise in bacterial resistance, few novel antibiotics have been developed in recent years, 5 necessitating optimization of currently available therapies.Īs a class, beta-lactam antibiotics exhibit time-dependent killing. The time required for drug discovery, research, and approval far exceeds the time typically observed for the development of resistance following widespread use of an antimicrobial. 1,3Īntimicrobial resistance consistently follows closely behind the development of new antimicrobials. 2 The World Health Organization and the Infectious Diseases Society of America have identified MDR organisms as one of the leading obstacles in modern medicine. 1 Infection with these pathogens has been associated with increased hospital length of stay, mortality, and overall healthcare costs. Difficulties in infection prevention and control, coupled with the overuse of antimicrobials, have accelerated the rise in incidence of bacterial resistance. Multidrug-resistant (MDR) organisms are a growing concern worldwide. Health systems are encouraged to explore and adopt this method of dosing. Data, although limited, suggest superior clinical outcomes with this modality. The broad-spectrum beta-lactams cefepime, meropenem, and piperacillin-tazobactam are the agents most studied for this dosing strategy, as they have reliable activity against most gram-negative organisms, including Pseudomonas aeruginosa. Pharmacokinetic and pharmacodynamic modeling have consistently shown that prolonging the infusion of beta-lactam antibiotics to 3 to 4 hours increases the achievement of this pharmacodynamic goal. Optimal efficacy with these agents is achieved when free drug concentrations remain above the minimum inhibitory concentration of the infecting organism for an extended duration of the recommended dosing interval. ABSTRACT: Beta-lactam antibiotics exhibit time-dependent killing.