Modern approaches enhancing the efficiency of antibiotic therapy in hospital practice
Authors:
Lukáš Bauer 1; Jan Cihlo 2
Authors‘ workplace:
Oddělení klinické farmacie, Fakultní nemocnice Bulovka, Praha
1; Lékárna Multiscan Pharma, s. r. o., Onkologické centrum Multiscan, s. r. o., Pardubice
2
Published in:
Čas. Lék. čes. 2025; 164: 3-8
Category:
Review Articles
Overview
The current effective antibiotic therapy requires modern approaches focused on optimizing treatment and slowing the growth of antimicrobial resistance.
A key tool in hospitals is the concept of antimicrobial stewardship, which relies on collaboration in multidisciplinary teams composed of infectious disease specialists, microbiologists, clinical pharmacists, and epidemiologists. These teams focus on the correct choice of antibiotic and its dosage, monitoring its effectiveness and minimising adverse effects.
Expanding possibilities in the field of monitoring and interpretation of plasma concentrations of an increasing number of antibiotics enable effective and safe optimization of dosing and administration methods (prolonged and continuous infusions) adjusted for individual patients, thereby allowing a personalized approach to pharmacotherapy. The optimization of antibiotic dosing is further supported using modern administration tools.
In the hospital setting, electronic parametric prescribing, centralized preparation and dispensing of anti-infectives by the hospital pharmacy also leads to improved safety. In outpatient care, possibilities are expanding with the concept of outpatient parenteral antimicrobial therapy, which reduces the risk of nosocomial infections and provides the comfort of a home environment for patients. However, its broader use is hindered mainly by the lack of official stability data for antibiotic preparations, as well as administrative and financial barriers associated with integrating this innovative concept into routine practice.
Keywords:
anti-bacterial agents, multidisciplinary care team, therapeutic drug monitoring, drug stability, drug infusion systems
Sources
- Tanzarella ES, Cutuli SL, Lombardi G et al. Antimicrobial de-escalation in critically ill patients. Antibiotics 2024; 13 : 375.
- Tabah A, Cotta MO, Garnacho-Montero J et al. A systematic review of the definitions, determinants, and clinical outcomes of antimicrobial de-escalation in the intensive care unit. Clin Infect Dis 2016; 62 : 1009–1017.
- Wolie ZT, Roberts JA, Gilchrist M et al. Current practices and challenges of outpatient parenteral antimicrobial therapy: a narrative review. J Antimicrob Chemother 2024; 79 : 2083–2102.
- Štefan M, Dlouhý P. OPAT – ambulantní parenterální antimikrobiální terapie. Společnost infekčního lékařství ČLS JEP, 2023. Dostupné na: https://infektologie.cz/Standardy/OPAT_DP_2023_05_17-2.pdf
- Roberts JA, Norris R, Paterson DL et al. Therapeutic drug monitoring of antimicrobials. Brit J Clin Pharmacol 2012; 73 : 27–36.
- Firman P, Tan K-S, Clavarino A et al. Pharmacist-managed therapeutic drug monitoring programs within Australian hospital and health services – a national survey of current practice. Pharmacy 2022; 10 : 1–11.
- Hong LT, Downes KJ, FakhriRavari A et al. International consensus recommendations for the use of prolonged-infusion beta-lactam antibiotics. Pharmacotherapy 2023; 43 : 740–777.
- Ramphal R. Optimizing the use of carbapenems in the face of increasing gram-negative resistance. Crit Care 2008; 12 (Suppl. 4): S1.
- Přehled léčiv. SÚKL. Dostupné na: https://prehledy.sukl.cz/prehled_leciv.html#/
- Národní ošetřovatelský postup zavedení a péče o periferní žilní katétr. Věstník MZ ČR 2020; 5.
- Bolla B, Buxani Y, Wong R et al. Understanding IV antimicrobial drug losses: the importance of flushing infusion administration sets. JAC Antimicrob Resist 2020; 2: dlaa061.
- Fady PE, Bennett N. Antibiotic underdosing and disposal in NHS organisations across Great Britain (1.0.2). Office of Baroness Bennett of Manor Castle. Zenodo, 2023. Dostupné na: https://zenodo.org/records/10284305
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
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