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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Therapeutic drug monitoring of beta-lactam antibiotics in burns patients-a one-year prospective study
Therapeutic Drug Monitoring, Volume 34, No. 2, Year 2012
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Description
Background: Beta-lactams are first-line antibiotics for the management of superficial infections due to burn injury. There is sparse data available on therapeutic drug monitoring (TDM) in patients with burns in a ward setting. This study was conducted to evaluate the utility of a beta-lactam TDM program in a cohort of burn injury patients in a ward environment. Methods: Steady-state blood samples were collected immediately before a scheduled dose. The therapeutic concentration targets assessed were (1) free antibiotic concentrations exceeding the minimum inhibitory concentration (MIC; fT > MIC) and (2) free concentrations ≥4× MIC of the known or suspected pathogen (fT > 4× MIC). The duration of therapy was also assessed. Results: A total of 50 patients were included for TDM over a 12-month period. The mean (±SD) age was 49 ± 16 years. The mean percent total body surface area burn was 17 ± 13%. The mean serum creatinine concentration was 86 ± 20 μmole/L. Sixty percent of the patients did not achieve fT > MIC, and only 18% achieved the higher target of fT > 4× MIC. Although all the patients achieved a positive clinical outcome, the duration of antibiotic treatment was shorter in patients who achieved fT > MIC compared with those who did not (4.2 ± 1.1 versus 5.3 ± 2.3 days; P = 0.03). Conclusions: We found TDM to be a reliable intervention for burn injury patients in a ward environment. This study supports pharmacokinetic data that burns patients may be at risk of subtherapeutic dosing, which may prolong the duration of antibiotic therapy. © 2012 Lippincott Williams & Wilkins.
Authors & Co-Authors
Paratz, Jennifer Davida
Australia, Brisbane
Royal Brisbane and Women's Hospital
Australia
Centre for Clinical Research
Paterson, David L.
Australia, Brisbane
Uq Centre for Clinical Research
Ungerer, Jacobus Petrus Johannes
Australia, Brisbane
Royal Brisbane and Women's Hospital
Lipman, Jeffrey
Australia, Brisbane
Royal Brisbane and Women's Hospital
Australia
Centre for Clinical Research
Roberts, Jason A.
Australia, Brisbane
Royal Brisbane and Women's Hospital
Australia
Centre for Clinical Research
Statistics
Citations: 60
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1097/FTD.0b013e31824981a6
ISSN:
15363694
Research Areas
Violence And Injury
Study Design
Randomised Control Trial
Cohort Study