0. Guide to Antimicrobial Therapy 2017 Cover

155 Pages·2017·0.72 MB·English

Cover design by Amer Syazwan bin Mohd Yazid ISBN 978 – 967 – 11415 – 3 – 3Pusat Kebangsaan ISBN Malaysia by any means without prior permission from the Publisher.All rights reserved. No part of this book may be reproduced in any form or Copyright © 2017 Malaysian Society of Intensive Care 57000 Kuala Lumpur, Wilayah PersekutuanJalan Innovasi 1, Lebuhraya Puchong - Sungei Besi, Bukit Jalil,Unit 1.6, Level 1, Enterprise 3B, Technology Park Malaysia (TPM), Malaysian Society of Intensive Care (MSIC)Published by drug information and clinical application.strongly encouraged to always keep abreast with developments in drug dosages are current and accurate. However the reader is recognised. The Writing Committee has endeavoured to ensure Dose schedules are being continually revised and new side effects
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iii Guide to Antimicrobial Therapy in the Adult ICU 2017Chairperson and Editor, Writing Committee forDr Louisa Chan it will be a useful compendium for daily practice.many hours of evidence review and exchange of opinions. We hope invaluable recommendations. This book has been a culmination of We would like to thank our reviewers for their expertise and data.over ride sound clinical judgement and local antibiotic-susceptibility However it must be emphasised that the recommendations do not guide for local doctors caring for the critically ill septic patient. The book remains true to its aims as a convenient up-to-date pocket has been dedicated to this.multidisciplinary approach to the handling of antibiotics. A chapter through poor prescribing habits. Antibiotic stewardship calls for a play a significant role in the propagation of resistant organisms fallacy. Often we are oblivious to the fact that we, the prescribers, The threat that one day antibiotics may be obsolete is not a need to revise this antimicrobial guide after five years.urgent to continually evaluate and apply this knowledge, hence the areas of pharmacokinetics and pharmacodynamics. It becomes and antibiotic use has markedly increased especially the latter in treatment. Like many areas of medicine the knowledge of sepsis in the ICU. The administration of antibiotics is imperative in its Sepsis still remains the leading cause of admissions and deaths FOREWORD
iv Kuala LumpurHospital Kuala LumpurPharmacistMs Kimberly Teh Hwei Lin Kuala LumpurHospital Kuala LumpurPharmacistMs Charlene Tay Kuala LumpurHospital Kuala LumpurDepartment of Anaesthesia and Intensive CaConsultant IntensivistDr Tai Li Ling SelangorUniversiti Putra MalaysiaFaculty of Medicine and Health SciencesSenior Lecturer and Consultant IntensivistDr Noor Airini Ibrahim Kuantan, PahangInternational Islamic University MalaysiaKulliyyah of MedicineDepartment of Anesthesiology and IntensiveConsultant IntensivistAssociate Professor Dato’ Dr Mohd Basri M Kuala LumpurHospital Kuala LumpurDepartment of Anaesthesia and Intensive CaConsultant IntensivistDr Louisa Chan (Chairperson and Editor) WRITING COMMI
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Johor Monash University Malaysia Health Sciences Jeffrey Cheah School of Medicine and Intensivist Associate Professor (Practice) andbin Mohd YunosAssociate Professor Dr Nor’az Singapore Tan Tock Seng Hospital Intensive Care and Pain Medicine Senior Consultant Anaesthesiology, Director Surgical Intensive Care UnitDr Jonathan Tan Pahang Kuantan Hospital Tengku Ampuan Afzan ICU Clinical PharmacistDr Janattul Ain Jamal Penang Loh Guan Lye Specialist Centre Anaesthesiologist Consultant Intensivist andDr Claudia Cheng Ai Yu (in alphabetical order) EXPERT
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Kuala Lumpur International Medical University Professor of PathologyProfessor Victor Lim Johor Johor Bahru Hospital Sultanah Aminah ICU Clinical PharmacistMr Tan Chee Chin Selangor Hospital Sungai Buloh Consultant Infectious Diseases SDr Suresh Kumar A/L Chidam Selangor Hospital Sungai Buloh Intensive Care Department of Anaesthesia and Consultant IntensivistDr Shanthi Ratnam VIEWERS
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vi by certain multi-drug resistant organisms.therapy in the treatment of ventilator-associated pneumonia caused Potential use of inhaled polymyxin and amikacin as adjunct to IV • IV imipenem 1g q8h for severe infections • IV gentamicin 3mg/kg q24h in endocarditis • IV cloxacillin 2g q4h • IV ceftazidime 2g q6h in melioidosis • IV ceftriaxone 1g q12h • IV cefepime 2g q8hOther new recommended dosing: cefoperazone. Cefoperazone increases the risk of coagulopathy.has been omitted, as it would exceed daily dose limits of The use of cefoperazone/sulbactam to deliver high dose sulbactam • Appendix on drug dosing in obesity. • Appendix on drugs affected by hypoalbuminaemia. • Expanded appendix on dose adjustment for renal failure. • Polymyxin and high-dose sulbactam dosing has changed. fluconazole, ceftriaxone. • Loading doses recommended for certain antibiotics e.g. dosing has been introduced:pharmacokinetics and pharmacodynamics of antibiotics, some new In line with more evidence and better understanding of A new chapter on antibiotic stewardship. SUMMARY OF IMPORTANT CHANGES
vii ) Appendix E – Drug Dosing in Obesity (BMI > 30kg/m2Appendix D – Extended or Continuous Infusions of ß-lactaAppendix C – Therapeutic Drug Dosing and Monitoring Appendix B – Dosage Adjustment for Hypoalbuminaemia Appendix A – Dosage Adjustment for Renal Impairment Invasive Candidiasis in the Non-neutropenic Patient Severe Malaria Leptospirosis Melioidosis Central Nervous System Infection Skin and Soft Tissue Infections Infective Endocarditis Catheter-Related Bloodstream Infection Urinary Tract Infection Peritonitis Liver Abscess Biliary Sepsis Acute Infective Pancreatitis Acute Infective Diarrhoea Tuberculosis Hospital-Acquired and Ventilator-Associated Pneumonia Aspiration Pneumonia and Lung Abscess Community-Acquired Pneumonia Microbiological Investigations Principles of Antimicrobial Therapy Antibiotic Stewardship in ICU Summary of Important Changes Expert Reviewers Writing Committee Foreword Contents TABLE OF CONTENTS
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