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Antibiotics
Special Issues
Epidemiology and Antimicrobial Dosing Regimens in Intensive Care Units
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Epidemiology and Antimicrobial Dosing Regimens in Intensive Care Units

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Pharmacokinetics and Pharmacodynamics of Drugs".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 726

Special Issue Editor

Prof. Dr. Philipp Simon

E-Mail Website
Guest Editor
Anesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, Augsburg, Germany
Interests: critical care; infections; sepsis; obesity; antibiotics; microdialysis; anesthesia; mechanical ventilation; electric impedance tomography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In addition to the choice of antibiotic and the duration of therapy in intensive care medicine, the correct dosage is also crucial for the success of anti-infective therapy and the avoidance of resistance development. The pharmacological concept of antibiotic therapy is based on achieving a sufficiently adequate antibacterial effect at the site of the bacterial infection. Distribution as a pharmacokinetic process depends on the pharmacological properties of the substances as well as physiological conditions.

Various influencing factors such as hepatic or renal insufficiency and obesity, as well as the effects of severe infections, including sepsis and its course, influence the pharmacokinetics of antibiotics to varying degrees and often make it necessary to adjust the dose. Especially in intensive care medicine in the treatment of serious life-threatening infections, this presents physicians with ever new challenges.

Nowadays, there are various approaches to dosing antibiotics in intensive care medicine with differing evidence and sometimes controversial discussion.

This Special Issue, entitled ‘Epidemiology and Antimicrobial Dosing Regimens in Intensive Care Units’, aims to publish current epidemiological findings and new developments in the dosing of antibiotics in intensive care. This Special Issue welcomes various types of submissions, such as original research papers, short communications, reviews, case reports, and perspectives.

Prof. Dr. Philipp Simon
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • epidemiology
  • critical care
  • sepsis
  • empiric therapy
  • dosing
  • interactions
  • antibiotic resistance
  • therapeutic drug monitoring
  • pharmacokinetics/pharmacodynamics
  • renal insufficiency
  • renal replacement therapy

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Published Papers (1 paper)

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Research

14 pages, 1307 KB  
Article
Impact of Obesity on Serum Concentrations of Vancomycin Administered as Continuous Infusion and on Clinical Outcomes in Critically Ill Patients—A Retrospective Observational Study
by Stefanie Nothofer, Rico Angeli, Manfred Weiss, Christian Dumps, Felix Berger, Josephin Eckert, Felix Girrbach, Nadin Scheidt, Susan Menzel, Mirko Lange, Hermann Wrigge and Philipp Simon
Antibiotics 2025, 14(9), 895; https://doi.org/10.3390/antibiotics14090895 - 4 Sep 2025
Viewed by 337
Abstract
Background/Objectives: Vancomycin is a commonly used antibiotic in critically ill patients with severe methicillin-resistant Staphylococcus aureus infections. Due to its narrow therapeutic window, under- or overdosing is likely to result in adverse effects, especially in patients with conditions associated with altered pharmacokinetics such [...] Read more.
Background/Objectives: Vancomycin is a commonly used antibiotic in critically ill patients with severe methicillin-resistant Staphylococcus aureus infections. Due to its narrow therapeutic window, under- or overdosing is likely to result in adverse effects, especially in patients with conditions associated with altered pharmacokinetics such as obesity. The objective of this study was to investigate the impact of obesity on serum concentrations of vancomycin in critically ill patients receiving intravenous vancomycin by continuous infusion based on ideal body weight (IBW). Methods: This retrospective observational study performed at the University Hospital of Leipzig, Germany, included all patients admitted to the intensive care unit (ICU) between January 2009 and December 2015 who received guideline-based vancomycin therapy based on IBW. Serum concentrations were obtained through routinely performed therapeutic drug monitoring (TDM). Results: A total of 1066 patients with a median age of 62 years were included in this study. The median (25%; 75% quantile) vancomycin treatment duration was 4 (2; 7) days and the median time to reach target concentrations of 20–25 mg L−1 was 3 (2; 4) days without a significant difference between BMI groups. Overall, only 25.9% of patients were in the therapeutic range of 20–25 mg L−1 in the entire treatment interval. 47.8% of vancomycin concentrations obtained from TDM were below the desired target range with no differences between the BMI groups (p = 0.077). 26.3% of measurements exceeded the target range, with a significant increase in the morbidly obese group (p < 0.001). A higher BMI was associated with an increased ICU, in-hospital, 28- and 90-day mortality in morbidly obese patients (p < 0.05). Age, BMI and high SAPS-II and SOFA scores were significant predictors of an increased risk of death. Conclusions: Our preliminary findings suggest that IBW-based dosing may help reduce the risk of supratherapeutic concentrations in morbidly obese patients. The high rates of sub- and supratherapeutic vancomycin serum concentrations across all patients highlight the need for close TDM and dose adjustments, particularly in morbidly obese patients with the highest rates of supratherapeutic vancomycin serum concentrations and of RRT. Full article
(This article belongs to the Special Issue Epidemiology and Antimicrobial Dosing Regimens in Intensive Care Units)
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