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DC Field | Value | Language |
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dc.contributor.author | Udy A.A. | en |
dc.contributor.author | Martin E.-L. | en |
dc.contributor.author | Schneider H.G.F. | en |
dc.contributor.author | Ngo-Thai L.L. | en |
dc.contributor.author | McGloughlin S.A. | en |
dc.contributor.author | Peleg A.Y. | en |
dc.contributor.author | Pai Mangalore R. | en |
dc.contributor.author | Padiglione A.A. | en |
dc.date.accessioned | 2021-05-14T09:49:16Z | en |
dc.date.available | 2021-05-14T09:49:16Z | en |
dc.date.copyright | 2020 | en |
dc.date.created | 20201024 | en |
dc.date.issued | 2020-10-24 | en |
dc.identifier.citation | Journal of Pharmacy Practice and Research. 50 (4) (pp 345-350), 2020. Date of Publication: 01 Aug 2020. | en |
dc.identifier.issn | 1445-937X | en |
dc.identifier.uri | https://repository.monashhealth.org/monashhealthjspui/handle/1/29102 | en |
dc.description.abstract | Aim: To determine if empirical anti-pseudomonal beta-lactam antibiotic (BLA) dosing achieves adequate drug exposure in septic patients. Method(s): A single-centre, prospective pharmacokinetic study was conducted in Intensive Care Unit (ICU) patients with sepsis, receiving empirical therapy with piperacillin/tazobactam or meropenem. The pharmacokinetic/pharmacodynamic (PK/PD) targets were free BLA concentrations above the MIC at the mid-point (Concentration A, 50%f T > MIC) and end of the dosing interval (Concentration B, 100% fT > MIC). Sub-therapeutic concentrations were defined as concentration A < MIC, and sub-optimal as concentration B < MIC. The MIC breakpoint for Pseudomonas aeruginosa, as defined by The European Committee on Antimicrobial Susceptibility Testing (EUCAST) (available from <http://www.eucast.org/clinical_breakpoints>) was used. Result(s): Of the 37 eligible patients, 20 were receiving piperacillin/tazobactam (TZP), and 17 meropenem (MEM). PK data were available for 36 patients (concentration A) and 34 patients (concentration B). The median measured plasma concentrations (mg/L) were: piperacillin for doses 4 g 8-hourly and 4 g 6-hourly - concentration A 53.9 [14.38-123.71] and 36.44 [13.38-107.45], concentration B 8.01 [2.57-71.08] and 27.31 [3.32-59.76], MEM for doses 1 g 8-hourly and 2 g 8-hourly - concentration A 12.49 [7.35-23.63] and 30.5, concentration B 7.47 [2.97-11.33] and 9.31. 27.8% (10 of 36) of patients had sub-therapeutic concentrations (concentration A) and 50% (17 of 34) had sub-optimal concentrations (concentration B). Conclusion(s): Our study confirms that sub-therapeutic unbound plasma anti-pseudomonal BLA concentrations are common in critically ill septic patients and underscores the urgent need for future trials exploring the efficacy of BLA therapeutic drug monitoring in these patients.Copyright © 2020 The Society of Hospital Pharmacists of Australia | en |
dc.language | English | en |
dc.language | en | en |
dc.publisher | Wiley-Blackwell (E-mail: info@wiley.com) | en |
dc.relation.ispartof | Journal of Pharmacy Practice and Research | en |
dc.title | Insufficient plasma concentrations of empiric anti-pseudomonal beta-lactam antibiotics in critically ill patients with suspected sepsis. | en |
dc.type | Article | en |
dc.identifier.affiliation | Infectious Diseases and Clinical Microbiology | - |
dc.type.studyortrial | Observational study (cohort, case-control, cross sectional or survey) | - |
dc.identifier.doi | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1002/jppr.1639 | - |
dc.publisher.place | Australia | en |
dc.identifier.source | 2005426218 | en |
dc.identifier.institution | (Pai Mangalore, Padiglione, McGloughlin, Peleg) Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia (Padiglione, Martin, Ngo-Thai, McGloughlin, Udy) Department of Hyperbaric and Intensive Care Medicine, The Alfred Hospital, Melbourne, Australia (Peleg) Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Melbourne, Australia (Padiglione) Department of Infectious Diseases, Monash Medical Centre, Clayton, Australia (Schneider) Department of Pathology, The Alfred Hospital, Melbourne, Australia (Martin, Ngo-Thai) Pharmacy, The Alfred Hospital, Melbourne, Australia (McGloughlin, Udy) School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia | en |
dc.description.address | R. Pai Mangalore, Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia. E-mail: R.Paimangalore@alfred.org.au | en |
dc.description.publicationstatus | Embase | en |
dc.rights.statement | Copyright 2020 Elsevier B.V., All rights reserved. | en |
dc.subect.keywords | beta-lactam antibiotics critically ill ICU pharmacodynamics pharmacokinetics sepsis TDM | en |
dc.identifier.authoremail | Pai Mangalore R.; R.Paimangalore@alfred.org.au | en |
dc.description.grant | No: Small Project Grant Organization: *Alfred Research Trusts, Alfred Health* Organization No: 501100002716 Country: Australia | en |
item.cerifentitytype | Publications | - |
item.fulltext | No Fulltext | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.grantfulltext | none | - |
item.openairetype | Article | - |
Appears in Collections: | Articles |
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