Background: Infection is common after burn injury and accounts for the most frequent complications of burn injury. This review describes the effects of burn injury on pharmacokinetics, focusing on the impact of these changes on antimicrobial therapy. Methods: The published literature on pharmacokinetics and pharmacodynamics in burn injury of antibiotic use was reviewed. Results: Physiologic and metabolic changes of burn injury can alter pharmacokinetic parameters, leading to larger volumes of distribution, faster hepatic metabolism, and increased renal clearance. Changes in pharmacokinetics may lead to subtherapeutic doses of commonly used antibiotic and antifungal agents. Conclusions: Although not all antimicrobial agents are well studied in the burn population, dose recommendations exist for some agents. Additional research is needed to cover the systemic antimicrobial agents used in the care of burn patients so that appropriate dosing adjustments can be made to optimize outcomes.
Keywords: antimicrobials; burn; pharmacodynamics; pharmacokinetics.