Do We Understand the Impact of Altered Physiology, Consequent Interventions and Resultant Clinical Scenarios in the Intensive Care Unit? the Antibiotic Story

Early, appropriate antibacterial therapy is a key factor in effectively managing septic critically ill patients 1 . The prescriber must not only employ an agent of appropriate spectrum, but also in an adequate dose to achieve bacterial eradication at the site of infection. However, the relationship between drug administration and therapeutic success is complex in the critically ill, such that a patient's physiology heavily influences the way drugs distribute into tissue and are eliminated. This represents a significant challenge to the emergency or intensive care physician, and in this manner, personalising therapy, through a greater understanding of how a drug will behave in an individual patient, is likely to lead to improved outcomes.