Dragana Milaković

The possibility of discovering new knowledge that can improve patients’ health is a great motivator. With the support of my family and a fantastic team of amazing people around me, I can expect increased motivation, energy, and, ultimately, great achievements.

Dragana Milaković, MPharm, worked in the Hospital Pharmacy Department of the University Clinical Center of the Republic of Srpska from 2010 to 2018. Since 2018, she has been working in the Department of Nuclear Medicine and Thyroid Gland Disease. She earned the title of Clinical Pharmacy Specialist from the University of Belgrade in 2016 and has further educated herself in radiopharmacy through projects with the International Atomic Energy Agency and CEEPUS program. She is also a PhD student at the Faculty of Pharmacy, University of Belgrade, in the Department of Pharmacokinetics and Clinical Pharmacy.

Dragana Milaković, MPharm, has participated as a study coordinator in over 10 clinical trials and is a member of the Pharmacy Chamber of the Republic of Srpska and the European Association of Hospital Pharmacists (EAHP).Her recent research focuses on the challenges of appropriate dosing of antimicrobials during extracorporeal membrane oxygenation (ECMO), with particular emphasis on linezolid, which has been poorly studied in this context.

Optimizing linezolid dosing for ECMO patients with COVID-19-related ARDS

The appropriate dosing of antimicrobials during extracorporeal membrane oxygenation (ECMO) is a significant challenge, mainly due to the lack of established guidelines. Linezolid, one of the few antimicrobials used in ECMO patients, has been poorly studied in this context and its pharmacokinetic (PK) and pharmacodynamic (PD) behavior in critically ill patients remains understudied. The research of Dragana Milaković, MPharm, addresses the need for more information on how to optimize linezolid dosing for COVID-19 patients with acute respiratory distress syndrome (ARDS) undergoing veno-venous ECMO (vv ECMO). The study aims to determine the optimal dosing regimen for linezolid based on PK/PD targets, given its concentration-dependent antimicrobial activity, in order to improve therapeutic outcomes and reduce side effects in this vulnerable population.

The study used a population pharmacokinetic (PopPK) model to compare two dosing regimens – 600 mg every 8 hours and 600 mg every 12 hours – for achieving PK/PD targets against Gram-positive pathogens. Results showed that the 8-hour regimen significantly increased the likelihood of meeting key therapeutic targets, such as time above the minimum inhibitory concentration (Tf>MIC) and fAUC(24)/MIC. This finding is vital for optimizing linezolid dosing in ECMO patients, improving pathogen eradication while minimizing side effects.

While the study demonstrates the potential benefits of the 8-hour dosing regimen, it also highlights the need for careful monitoring due to the increased risk of thrombocytopenia associated with the higher dose. Overall, this research contributes valuable insights into the pharmacokinetics of linezolid in ECMO patients and provides a more effective dosing strategy to improve clinical outcomes for critically ill patients, specifically those with COVID-19-related ARDS.
 

From passion to practice – a commitment to advancing patient health

For Dragana Milaković, MPharm, the possibility of discovering new knowledge that improves patients' health serves as a great motivator. With the support of her family and a dedicated team of incredible people around her, she finds herself driven by increased motivation, energy and achieving great things. 

Applying natural sciences to everyday life has always brought her joy, a passion she’s had since her elementary school years. While her decision to become a pharmacist was accidental, it has proven to be an excellent choice. Working in a hospital environment, helping patients, providing advice, acquiring new knowledge and sharing that knowledge is truly invaluable to her.