Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
DALI: Defining antibiotic levels in intensive care unit patients: Are current ß-lactam antibiotic doses sufficient for critically ill patients?
Clinical Infectious Diseases, Volume 58, No. 8, Year 2014
Notification
URL copied to clipboard!
Description
Background. Morbidity and mortality for critically ill patients with infections remains a global healthcare problem. We aimed to determine whether α-lactam antibiotic dosing in critically ill patients achieves concentrations associated with maximal activity and whether antibiotic concentrations affect patient outcome.Methods. This was a prospective, multinational pharmacokinetic point-prevalence study including 8 α-lactam antibiotics. Two blood samples were taken from each patient during a single dosing interval. The primary pharmacokinetic/pharmacodynamic targets were free antibiotic concentrations above the minimum inhibitory concentration (MIC) of the pathogen at both 50% (50% f TMIC) and 100% (100% f T MIC) of the dosing interval. We used skewed logistic regression to describe the effect of antibiotic exposure on patient outcome.Results. We included 384 patients (361 evaluable patients) across 68 hospitals. The median age was 61 (interquartile range [IQR], 48-73) years, the median Acute Physiology and Chronic Health Evaluation II score was 18 (IQR, 14-24), and 65% of patients were male. Of the 248 patients treated for infection, 16% did not achieve 50% f TMIC and these patients were 32% less likely to have a positive clinical outcome (odds ratio [OR], 0.68; P =. 009). Positive clinical outcome was associated with increasing 50% f TMIC and 100% f TMIC ratios (OR, 1.02 and 1.56, respectively; P <. 03), with significant interaction with sickness severity status.Conclusions. Infected critically ill patients may have adverse outcomes as a result of inadeqaute antibiotic exposure; a paradigm change to more personalized antibiotic dosing may be necessary to improve outcomes for these most seriously ill patients. © 2014 The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Roberts, Jason A.
Australia, Brisbane
Royal Brisbane and Women's Hospital
Paul, Sanjoy K.
Australia, Brisbane
Qimr Berghofer Medical Research Institute
Australia, Brisbane
The University of Queensland
Akova, Murat
Turkey, Ankara
Hacettepe Üniversitesi
Bassetti, Matteo
Italy, Udine
Presidio Ospedaliero Universitario Santa Maria Della Misericordia , Udine
De Waele, Jan J.
Belgium, Ghent
Universitair Ziekenhuis Gent
Dimopoulos, George T.
Greece, Athens
Attikon University Hospital
Koulenti, Despoina
Australia, Brisbane
Royal Brisbane and Women's Hospital
Greece, Athens
Attikon University Hospital
Martin, Claude D.
France, Marseille
Hôpital Nord Ap-hm
Montravers, Philippe
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Rello, Jordi
Spain, Barcelona
Vall D'hebron Institut de Recerca
Rhodes, Andrew
United Kingdom, London
St George’s, University of London
Starr, Therese
Australia, Brisbane
Royal Brisbane and Women's Hospital
Wallis, Steven C.
Australia, Brisbane
Royal Brisbane and Women's Hospital
Lipman, Jeffrey
Australia, Brisbane
Royal Brisbane and Women's Hospital
Spapen, Herbert D.M.H.
Belgium, Jette
Universitair Ziekenhuis Brussel
Dugernier, Thierry L.
Belgium, Ottignies
Clinique Saint-pierre of Ottignies
Jorens, Philippe Germaine
Belgium, Edegem
Universitair Ziekenhuis Antwerpen
de Backer, Daniel P.
Belgium, Brussels
Hôpital Erasme
Taccone, Fabio Silvio S.
Belgium, Brussels
Hôpital Erasme
Afonso, Elsa Da Palma
Spain, Barcelona
Vall D'hebron Institut de Recerca
Spain, Barcelona
Hospital Universitari Vall D'hebron
Vidaur, Loreto
Spain, Leganes
Hospital Universitario Severo Ochoa
Esperatti, Mariano
Spain, Barcelona
Hospital Clinic Barcelona
Spain, Madrid
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Torres, Antoni
Spain, Barcelona
Hospital Clinic Barcelona
Spain, Madrid
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Dupont, Hervé
France, Amiens
Chu Amiens Picardie
Mahjoub, Yazine
France, Aix-en-provence
Centre Hospitalier du Pays D'aix
Lasocki, Sigismond
France, Amiens
Chu Amiens Picardie
Constantin, Jean Michel
France, Clermont-ferrand
Centre Hospitalier Universitaire de Clermont-ferrand
Lefrant, Jean Yves
France, Nimes
Centre Hospitalier Universitaire de Nîmes
Jaber, Samir
France, Montpellier
Centre Hospitalier Universitaire de Montpellier
Joannès-Boyau, Olivier
France, Talence
Centre Hospitalier Universitaire de Bordeaux
Ostermann, Marlies Elizabeth
United Kingdom, London
St Thomas' Hospital
Rubulotta, Francesca M.
United Kingdom, London
Charing Cross Hospital
Gordon, Anthony C.
United Kingdom, London
Charing Cross Hospital
Brett, Stephen J.
United Kingdom, London
Hammersmith Hospital
Pettilã., Ville Y.O.
Finland, Helsinki
Helsinki University Hospital
Myrianthefs, Pavlos M.
Unknown Affiliation
Gkiokas, Georgios A.
Greece, Athens
Aretaio Hospital
Akoumianaki, Evangelia
Greece, Heraklion
Heraklion University Hospital
Koulouras, Vasilios P.
Greece, Ioannina
University General Hospital of Ioannina
Nakos, George
Greece, Ioannina
University General Hospital of Ioannina
Zafeiridis, Tilemachos
Unknown Affiliation
Arvaniti, Kostoula
Unknown Affiliation
Matamis, Dimitrios
Unknown Affiliation
Cortegiani, Andrea
Italy, Palermo
Università Degli Studi Di Palermo
Ranieri, V. Marco
Unknown Affiliation
Sandroni, Claudio
Italy, Rome
Università Cattolica Del Sacro Cuore, Facoltà Di Medicina e Chirurgia
De Pascale, Gennaro D.
Italy, Rome
Università Cattolica Del Sacro Cuore, Facoltà Di Medicina e Chirurgia
Pelosi, Paolo P.
Italy, Genoa
Università Degli Studi Di Genova
De Rosa, Francesco Giuseppe
Unknown Affiliation
Statistics
Citations: 764
Authors: 49
Affiliations: 66
Identifiers
Doi:
10.1093/cid/ciu027
ISSN:
10584838
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Participants Gender
Male