Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial

Autor:	Andrew A. Udy, Joel M. Dulhunty, Jason A. Roberts, Joshua S. Davis, Steven A.R. Webb, Rinaldo Bellomo, Charles Gomersall, Charudatt Shirwadkar, Glenn M. Eastwood, John Myburgh, David L. Paterson, Therese Starr, Sanjoy K. Paul, Jeffrey Lipman, Glenn Eastwood, Leah Peck, Helen Young, Catherine Boschert, Jason Fletcher, Julie Smith, Kiran Nand, Treena Sara, Amy Harney, Helen Rodgers, Frank Van Haren, Sally Clarke, David Durham, Catherine Hannan, Elisha Matheson, Kate Schwartz, Karen Thomas, Allison Bone, Claire Cattigan, Tania Elderkin, Tania Salerno, Robert Cameron, Katrina Ellis, Sheridan Hatter, Joshua Davis, Milind Sanap, Natalie Soar, Josette Wood, Karen Chan, Aaron Heffernan, Nai An Lai, Catherine Moss, Kate Sheehy, Maree Duroux, Megan Ratcliffe, Samantha Shone, Timothy Warhurst, Joel Dulhunty, Rachel Dunlop, David Paterson, Jason Roberts, Janine Stuart, Andrew Udy, David Cooper, Rick McAllister, Steve Webb, Andrew Cheng, Deborah Inskip, Jennene Miller, Serena Knowles, Claire Reynolds, Sam Rudham, Stuart Baker, Kristy Hepburn, Brigit Roberts, Paul Woods, Indranil Chatterjee, Judy Smith, Martin Cullen, Jing Kong, Vineet Nayyar, Christina Whitehead, Patricia Leung, Eileen Gilder, Lianne McCarthy, Shay McGuiness, Rachael Parke, Kirsten Benefield, Yan Chen, Colin McArthur, Lynette Newby, Seton Henderson, Jan Mehrtens, Sascha Noble, Lesley Chadwick, Ross Freebain, Chantal Hogan, Alex Kazemi, Laura Rust, Rima Song, Anna Tilsley, Anthony Williams, John Durning, Robert Frengley, Mary La Pine, Geoff McCracken, Swarna Baskar Sharma, Lynn Andrews, Richard Dinsdale, Anna Hunt, Sally Hurford, Diane Mackle, Jessica Ongley, Paul Young, Marin Kollef, John Turnidge, Sanjoy Paul
Přispěvatelé:	Udy, Andrew A, Dulhunty, Joel M, Roberts, Jason A, Davis, Joshua S, Turnidge, John, Paul, Sanjoy K
Rok vydání:	2017
Předmět:	Adult Male Microbiology (medical) augmented renal clearance medicine.medical_specialty Metabolic Clearance Rate medicine.medical_treatment Renal function beta-Lactams Placebo Cohort Studies sepsis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Sepsis Internal medicine medicine Humans critical illness Pharmacology (medical) 030212 general & internal medicine Renal replacement therapy Infusions Intravenous Aged Creatinine business.industry Organ dysfunction Acute kidney injury 030208 emergency & critical care medicine Bacterial Infections General Medicine Middle Aged medicine.disease Anti-Bacterial Agents Surgery Clinical trial Treatment Outcome Infectious Diseases chemistry Female medicine.symptom business ß-lactams Cohort study
Zdroj:	International Journal of Antimicrobial Agents. 49:624-630
ISSN:	0924-8579
Popis:	Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded. Primary outcome was alive ICU-free days at Day 28. Secondary outcomes included 90-day mortality and clinical cure at 14 days following antibiotic cessation. A total of 254 patients were included, among which 45 (17.7%) manifested ARC [median (IQR) CLCr 165 (144–198) mL/min]. ARC patients were younger (P
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::31a429fab023a2146fb3fa2d6607f5df https://doi.org/10.1016/j.ijantimicag.2016.12.022 Zobrazit plný text záznamu Full Text from ScienceDirect