Dosage des antibiotiques en réanimation : quand et comment demander et interpréter les tests ?

The monitoring of the serum antibiotic concentrations is very important in intensive care patients, with serious disturbances modifying the pharmacokinetics of the molecules used. Among them, it is necessary to distinguish those exhibiting a "time-dependent" activity (beta-lactam antibiotics, glycopeptides, linezolid), vs those exhibiting a "concentration-dependent" activity (aminosides, fluoroquinolones). The monitoring of the concentrations to the peak, residual, or at the steady-state makes it possible to adjust the daily amounts and the intervals of administration, by adapting the treatment to the pharmacodynamic and toxicological requirements of antibiotic used.