Beta‐lactam antibiotic concentrations in critically ill patients with standard and adjusted dosages: A prospective observational study
Authors' conclusion
The current standard dosing regimens employed during the study were not sufficient to reach 100% ƒT > MIC in approximately a quarter of the patients. In patients where dose adjustment was performed, the group with increased dose also had low target attainment, as opposed to patients with dose reduction, who all reached target.
Study context
- Population
- Critically ill intensive care unit (ICU) patients with confirmed or suspected infection receiving beta-lactam antibioticssingle ICU
- Participants
- 102 patients
- Exposure
- Cefotaxime, piperacillin/tazobactam and meropenem; standard, reduced or increased dosing
- Cefotaximen = 38
- Piperacillin/tazobactamn = 30
- Meropenemn = 34
- Outcome
- Free antibiotic concentration above MIC during the whole dosing interval (100% ƒT > MIC)
Methodological detailssingle-centre, Mid-dose and trough values collected during a single dosing interval
- Single-centre
- Mid-dose and trough values collected during a single dosing interval
Main finding
As reported in the abstract
100% ƒT > MIC
- All patients reaching 100% ƒT > MIC
- 78 patients (76%)
Observational data: associations, not effects.
Secondary outcomes
100% ƒT > 4MIC
- 100% ƒT > 4MIC — All patients reaching 100% ƒT > 4MIC
- 40 (39%)
Target attainment by dosing (100% ƒT > MIC; 100% ƒT > 4MIC)
- Standard dose: 100% ƒT > MIC
- 71%
- Standard dose: 100% ƒT > 4MIC
- 37%
- Reduced dose: 100% ƒT > 4MIC
- 27%
- Increased dose: 100% ƒT > MIC
- 79%
- Increased dose: 100% ƒT > 4MIC
- 48%
- Reduced dose: 100% ƒT > MIC (all patients)
Original publication
Beta‐lactam antibiotic concentrations in critically ill patients with standard and adjusted dosages: A prospective observational study. Acta Anaesthesiol Scand. Published 26 February 2024. doi:10.
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