Table 2 Summary of time-dependent antibiotics and proposed targets for TDM dose adjustments
PK/PD index | Antibiotics | PK/PD thresholds associated with optimal bacterial killing and/or clinical outcome | PK/PD threshold for potential toxicity |
|---|---|---|---|
fT>MIC | Beta-lactams | Predominantly 100% fT>MIC for TDM purposes [22] | Has not been clearly defined. Thresholds from 100% fT>6xMIC to 100% fT>10xMIC has been arbitrarily chosen by some centres [22] |
Penicillins | 30% fT>MIC (bacteriostatic) | ||
50% fT>MIC (bactericidal – animal model and clinical studies in non-critically ill patients) [154] | |||
Cephalosporins | 40–70% fT>MIC (animal models) [154] | ||
100% fT>MIC up to 100% fT>4–5xMIC (optimal clinical outcome observed for cefepime and ceftazidime) [18, 37] | |||
Carbapenems | 20% fT>MIC (bacteriostatic) | ||
40% fT>MIC (bactericidal) | |||
100% fT>5xMIC (optimal clinical outcome observed for meropenem) [155] | |||
Monobactams | 50% fT>MIC (bactericidal) | ||
Linezolid | Â |