Pharmakokinetische und metabolische Besonderheiten der Antibiotikaanwendung bei Kindern und älteren Menschen

Le résumé fourni par la source

The efficacy of antimicrobial therapies depends on achieving a pharmacokinetic/pharmacodynamic target. Therefore, correct dosing is crucial for the efficacy and safety of antimicrobial therapies. This article provides an overview of the pharmacological considerations of antimicrobial therapy in older adults and children. These groups, in particular, face an increased risk of improper dosage, as standardized dosing regimens are generally based on studies in middle-aged adults and may not adequately reflect individuals with different pharmacokinetics (absorption, distribution, metabolism, and excretion; PK) and pharmacodynamics (interaction with the pathogen and therapeutic effect; PD). However, incorrect dosing increases the likelihood of treatment failure, the development of antimicrobial resistance, and side effects.In older adults, absorption, distribution, metabolism, and elimination of the anti-infective agent can be affected by reduced absorption, changes in body composition, reduced liver and kidney function, and polypharmacy. In children, relevant aspects are age-related differences in organ maturation, enzyme activity, and glomerular filtration rate. These factors can impair treatment success and can lead to subtherapeutic doses, thus fostering selection of resistant microorganisms.For older adults and children, individualized dose adjustments that take into account their pharmacokinetic specifics are therefore necessary. In addition, thorough patient education and support are essential to ensure efficacy, safety, and adherence as well as to prevent the spread of resistance.

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