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Dosing in sepsis

What are the physiological changes in sepsis that can affect aminoglycoside dosing? In this article, Sally Tipping describes PK/PD changes that occur.
Intensive care scene with a stats monitor and IV drip
In this step, we will discuss dosing of aminoglycosides in treatment of sepsis.

Sepsis, which can be life-threatening, is not an infection type in itself but is defined as the body’s systemic immunological response to an infection. Left untreated, it can lead to severe organ dysfunction and death. Patients with sepsis can progress to septic shock with persistently low blood pressure and will require intensive monitoring and treatment due to organ failure. Using the right antimicrobials at the right dose promptly is important as part of successful treatment.

A number of pathophysiological changes can occur in critically ill patients with infections. These can alter the PK and PD properties of aminoglycosides, potentially resulting in a lower Cmax and, thus, reduced efficacy due to the concentration-dependent activity pattern.

Take a few moments to consider the question below. Add your thoughts to the comments section at the bottom of this step. Question bubble 'can you think of changes that might occur in sepsis to affect aminoglycosides treatment?'

Once you have thought about your answers, scroll down to the table below, which shows several changes that can occur.

table showing three examples of changes occurring in sepsis that can lead to reduced efficacy of aminoglycoside treatment, which includes: kidney function, volume of distribution (Vd) and multidrug resistant organisms are frequently seen in the critically ill.

If you require a screen reader-compatible version this is available as a PDF.

After reading through the table above, move on to the next step where you will be provided with a set of questions to answer and discuss with your fellow learners.

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Optimise Aminoglycoside Use in Clinical Practice

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