SPECIFIC FEATURES OF PHARMACOKINETICS AND PHARMACODYNAMICS OF ANTIBACTERIAL DRUGS USED FOR INTENSIVE THERAPY
The general principles of the antibacterial drugs pharmacokinetics and pharmacodynamics as well as specific features of their use for managing critically ill patients are described. The antibiotics are divided on hydrophilic and lypophilic depending on their physic and chemical profile. The hydrophilic antibiotics (aminoglycosides, ^-lactams, glycopeptides, colistin) pharmacokinetics is susceptive to impact of the pathophysiological processes observed under critical states and resulting in changing of the creatinine volume distribution and clearance to the utmost. The lypophilic antibiotics (fluoroquinolones, macrolides, tigecycline, lincosamides) are not characterized by the volume distribution changing in critically ill patients though their clearance can get changed. The data on the antibacterial drugs pharmacokinetics allows optimize their dosage mode considering the pharmacokinetic variations. Knowledge of the antibacterial drugs pharmacodynamic characteristics and the pharmacokinetics potential changes in critically ill patients allows individualize the dosage mode for each clinical situation. Therapeutic drug monitoring may be performed in order to optimize the therapy efficiency and minimize resistance when certain antibiotics are administered in accordance with individual dosage modes.