Publications
Guidelines for Antibiotics Prescription in Critically Ill Patients
Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, Todi SK, Mohan A, Hegde A, Jagiasi BG, Krishna B, Rodrigues C, Govil D, Pal D, Divatia JV, Sengar M, Gupta M, Desai M, Rungta N, Prayag PS, Bhattacharya PK, Samavedam S, Dixit SB, Sharma S, Bandopadhyay S, Kola VR, Deswal V, Mehta Y, Singh YP, Myatra SN Abstract
How to cite this article: Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, et al. Guidelines for Antibiotics Prescription in Critically Ill Patients. Indian J Crit Care Med 2024;28(S2):S104–S216.
Keywords: Antibiotics, Guidelines, Intensive care unit, Infections, Prescription
Executive Summary
Pharmacokinetics and Pharmacodynamics
Evidence Statement
Time-dependent antibiotics require drug concentrations greater than the minimum inhibitory concentration (MIC) for a certain time period between doses, which usually ranges from 40 to 50% of inter-dose interval for their best action. Continuous infusions are preferred over extended infusions for beta-lactam antibiotics and are associated with clinical benefits like decrease in hospital stay, cost of therapy and mortality. For vancomycin, continuous infusion is associated with reduced toxicity and cost of therapy but no mortality benefit.