DALI: Defining Antibiotic Levels in Intensive Care Unit Patients: Are Current -Lactam Antibiotic Doses Sufficient for Critically Ill Patients?

Autor:	Roberts JA, Lipman J, Starr T, Wallis SC, Paul SK, Margarit Ribas A, De Waele JJ, De Crop L, Spapen H, Wauters J, Dugernier T, Jorens P, Dapper I, De Backer D, Taccone FS, Rello J, Ruano L, Afonso E, Alvarez Lerma F, Gracia Arnillas MP, Fernández F, Feijoo N, Bardolet N, Rovira A, Garro P, Colon D, Castillo C, Fernado J, Lopez MJ, Fernandez JL, Arribas AM, Teja JL, Ots E, Carlos Montejo J, Catalan M, Prieto I, Gonzalo G, Galvan B, Blasco MA, Meyer E, Del Nogal F, Vidaur L, Sebastian R, Garde PM, Martin Velasco Mdel M, Zaragoza Crespo R, Esperatti M, Torres A, Montravers P, Baldesi O, Dupont H, Mahjoub Y, Lasocki S, Constantin JM, Payen JF, Martin C, Albanese J, Malledant Y, Pottecher J, Lefrant JY, Jaber S, Joannes Boyau O, Orban C, Ostermann M, McKenzie C, Berry W, Smith J, Lei K, Rubulotta F, Gordon A, Brett S, Stotz M, Templeton M, Rhodes A, Ebm C, Moran C, Kaukonen KM, Pettilä V, Dimopoulos G, Koulenti D, Xristodoulou A, Theodorou V, Kouliatsis G, Sertaridou E, Anthopoulos G, Choutas G, Rantis T, Karatzas S, Balla M, Papanikolaou M, Myrianthefs P, Gavala A, Fildisis G, Koutsoukou A, Kyriakopoulou M, Petrochilou K, Kompoti M, Michalia M, Clouva Molyvdas FM, Gkiokas G, Nikolakopoulos F, Psychogiou V, Malliotakis P, Akoumianaki E, Lilitsis E, Koulouras V, Nakos G, Kalogirou M, Komnos A, Zafeiridis T, Chaintoutis C, Arvaniti K, Matamis D, Kydona C, Gritsi Gerogianni N, Giasnetsova T, Giannakou M, Soultati I, Chytas I, Antoniadou E, Antipa E, Lathyris D, Koukoubani T, Paraforou T, Spiropoulou K, Bekos V, Spring A, Kalatzi T, Nikolaou H, Laskou M, Strouvalis I, Aloizos S, Kapogiannis S, Soldatou O, Bassetti M, Adembri C, Villa G, Montalto F, Strano MT, Ranieri VM, Sandroni C, De Pascale G, Molin A, Pelosi P, Montagnani L, Urbino R, Mastromauro I, De Rosa FG, Cardoso T, Afonso S, Gonçalves Pereira J, Baptista JP, Akova M, Ozveren A., GIARRATANO, Antonino, RAINERI, Santi Maurizio, CORTEGIANI, Andrea
Přispěvatelé:	Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Roberts JA, Lipman J, Starr T, Wallis SC, Paul SK, Margarit Ribas A, De Waele JJ, De Crop L, Spapen H, Wauters J, Dugernier T, Jorens P, Dapper I, De Backer D, Taccone FS, Rello J, Ruano L, Afonso E, Alvarez-Lerma F, Gracia-Arnillas MP, Fernández F, Feijoo N, Bardolet N, Rovira A, Garro P, Colon D, Castillo C, Fernado J, Lopez MJ, Fernandez JL, Arribas AM, Teja JL, Ots E, Carlos Montejo J, Catalan M, Prieto I, Gonzalo G, Galvan B, Blasco MA, Meyer E, Del Nogal F, Vidaur L, Sebastian R, Garde PM, Martin Velasco Mdel M, Zaragoza Crespo R, Esperatti M, Torres A, Montravers P, Baldesi O, Dupont H, Mahjoub Y, Lasocki S, Constantin JM, Payen JF, Martin C, Albanese J, Malledant Y, Pottecher J, Lefrant JY, Jaber S, Joannes-Boyau O, Orban C, Ostermann M, McKenzie C, Berry W, Smith J, Lei K, Rubulotta F, Gordon A, Brett S, Stotz M, Templeton M, Rhodes A, Ebm C, Moran C, Kaukonen KM, Pettilä V, Dimopoulos G, Koulenti D, Xristodoulou A, Theodorou V, Kouliatsis G, Sertaridou E, Anthopoulos G, Choutas G, Rantis T, Karatzas S, Balla M, Papanikolaou M, Myrianthefs P, Gavala A, Fildisis G, Koutsoukou A, Kyriakopoulou M, Petrochilou K, Kompoti M, Michalia M, Clouva-Molyvdas FM, Gkiokas G, Nikolakopoulos F, Psychogiou V, Malliotakis P, Akoumianaki E, Lilitsis E, Koulouras V, Nakos G, Kalogirou M, Komnos A, Zafeiridis T, Chaintoutis C, Arvaniti K, Matamis D, Kydona C, Gritsi-Gerogianni N, Giasnetsova T, Giannakou M, Soultati I, Chytas I, Antoniadou E, Antipa E, Lathyris D, Koukoubani T, Paraforou T, Spiropoulou K, Bekos V, Spring A, Kalatzi T, Nikolaou H, Laskou M, Strouvalis I, Aloizos S, Kapogiannis S, Soldatou O, Bassetti M, Adembri C, Villa G, Giarratano A, Raineri SM, Cortegiani A, Montalto F, Strano MT, Ranieri VM, Sandroni C, De Pascale G, Molin A, Pelosi P, Montagnani L, Urbino R, Mastromauro I, De Rosa FG, Cardoso T, Afonso S, Gonçalves-Pereira J, Baptista JP, Akova M, Ozveren A, Roberts, J.A., Paul, S.K., Akova, M., Bassetti, M., De Waele, J.J., Dimopoulos, G., Kaukonen, K.-M., Koulenti, D., Martin, C., Montravers, P., Rello, J., Rhodes, A., Starr, T., Wallis, S.C., Lipman, J., Margarit Ribas, A., De Crop, L., Spapen, H., Wauters, J., Dugernier, T., Jorens, P., Dapper, I., De Backer, D., Taccone, F.S., Ruano, L., Afonso, E., Alvarez-Lerma, F., Gracia-Arnillas, M.P., Fernández, F., Feijoo, N., Bardolet, N., Rovira, A., Garro, P., Colon, D., Castillo, C., Fernado, J., Lopez, M.J., Fernandez, J.L., Arribas, A.M., Teja, J.L., Ots, E., Carlos Montejo, J., Catalan, M., Prieto, I., Gonzalo, G., Galvan, B., Blasco, M.A., Meyer, E., Del Nogal, F., Vidaur, L., Sebastian, R., Garde, P.M., Martin Velasco, M.D.M., Zaragoza Crespo, R., Esperatti, M., Torres, A., Baldesi, O., Dupont, H., Mahjoub, Y., Lasocki, S., Constantin, J.M., Payen, J.F., Albanese, J., Malledant, Y., Pottecher, J., Lefrant, J.-Y., Jaber, S., Joannes-Boyau, O., Orban, C., Ostermann, M., McKenzie, C., Berry, W., Smith, J., Lei, K., Rubulotta, F., Gordon, A., Brett, S., Stotz, M., Templeton, M., Ebm, C., Moran, C., Pettilä, V., Xristodoulou, A., Theodorou, V., Kouliatsis, G., Sertaridou, E., Anthopoulos, G., Choutas, G., Rantis, T., Karatzas, S., Balla, M., Papanikolaou, M., Myrianthefs, P., Gavala, A., Fildisis, G., Koutsoukou, A., Kyriakopoulou, M., Petrochilou, K., Kompoti, M., Michalia, M., Clouva-Molyvdas, F.-M., Gkiokas, G., Nikolakopoulos, F., Psychogiou, V., Malliotakis, P., Akoumianaki, E., Lilitsis, E., Koulouras, V., Nakos, G., Kalogirou, M., Komnos, A., Zafeiridis, T., Chaintoutis, C., Arvaniti, K., Matamis, D., Kydona, C., Gritsi-Gerogianni, N., Giasnetsova, T., Giannakou, M., Soultati, I., Chytas, I., Antoniadou, E., Antipa, E., Lathyris, D., Koukoubani, T., Paraforou, T., Spiropoulou, K., Bekos, V., Spring, A., Kalatzi, T., Nikolaou, H., Laskou, M., Strouvalis, I., Aloizos, S., Kapogiannis, S., Soldatou, O., Adembri, C., Villa, G., Giarratano, A., Maurizio Raineri, S., Cortegiani, A., Montalto, F., Strano, M.T., Ranieri, V.M., Sandroni, C., De Pascale, G., Molin, A., Pelosi, P., Montagnani, L., Urbino, R., Mastromauro, I., De Rosa, F.G., Cardoso, T., Afonso, S., Gonçalves-Pereira, J., Baptista, J.P., Özveren, A., İç Hastalıkları, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Jazyk:	angličtina
Rok vydání:	2014
Předmět:	Male International Cooperation Antibiotics adverse event intensive care unit law.invention 0302 clinical medicine meropenem Models [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases adverse events continuous infusion extended infusion pharmacodynamics pharmacokinetics Aged Anti-Bacterial Agents Bacterial Infections Blood Chemical Analysis Female Humans Intensive Care Units Microbial Sensitivity Tests Middle Aged Models Statistical Prospective Studies Treatment Outcome beta-Lactams Critical Illness antibiotic therapy amoxicillin plus clavulanic acid ComputingMilieux_MISCELLANEOUS beta lactam antibiotic APACHE 0303 health sciences critical illne adult clinical trial 3. Good health antiinfective agent [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology priority journal disease severity beta-Lactam statistical model Aged prospective study Human Microbiology (medical) medicine.medical_specialty drug exposure Immunology bloodstream infection piperacillin plus tazobactam Microbiology beta lactam abdominal infection 03 medical and health sciences critically ill patient Intensive care Anti-Bacterial Agent cefepime Dosing Adverse effect 030306 microbiology Odds ratio major clinical study mortality antibiotic sensitivity ceftriaxone Prospective Studie multicenter study ampicillin Ceftazidime Settore MED/41 - Anestesiologia Interquartile range law 030212 general & internal medicine pharmacokinetic lung infection Microbial Sensitivity Test article Statistical Intensive care unit Infectious Diseases cefazolin [SDV.IMM]Life Sciences [q-bio]/Immunology blood sampling medicine.drug medicine.drug_class prevalence doripenem minimum inhibitory concentration Bacterial Infection Internal medicine medicine controlled study blood analysi business.industry Blood Chemical Analysi Surgery pharmacodynamic drug blood level business
Zdroj:	Clinical Infectious Diseases Clinical Infectious Diseases, Oxford University Press (OUP), 2014, 58 (8), pp.1072-1083. ⟨10.1093/cid/ciu027⟩
ISSN:	1058-4838 1537-6591
DOI:	10.1093/cid/ciu027⟩
Popis:	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
Databáze:	OpenAIRE
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