Tamara van Donge

Chapter 3 46 Figure 2: Conceptual visualization of impact of efficacy and toxicity during antibiotic treatment. During the empirical phase, focus lies on an efficacious treatment and when sepsis is confirmed (~ 3 days) treatment can be individualized and focus should shift to the safety of treatment. Key components in understanding pharmacological concepts Clinical pharmacology aims to predict both efficacy and safety based on drug properties, population or individual pharmacokinetic behavior (PK) and pharmacodynamic, microbiological characteristics (PD). In order to understand optimal and individualized dosing of antibiotic treatment, one should be aware of the drug related processes in the human body and their influences on each other (Figure 3). Dose and administration A drug can have several formulations and can be administered through various routes, intravenous and oral being the most frequently used (Figure 3, A). The route and method of administration can influence both PK and PD processes, and therefore needs to be considered when determining optimized dosing recommendations. Aminoglycosides are preferable administered via intravenous bolus dosage to achieve efficacious peak concentrations, due to concentration dependent properties. In contrast, intramuscular administration is often applied in low- and middle-income countries due to practicability.