DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic

被引:43
作者
Roberts, Jason A. [1 ,2 ]
De Waele, Jan J. [3 ]
Dimopoulos, George [4 ]
Koulenti, Despoina [4 ]
Martin, Claude [5 ]
Montravers, Philippe [6 ]
Rello, Jordi [7 ]
Rhodes, Andrew [8 ,9 ]
Starr, Therese [2 ]
Wallis, Steven C. [1 ]
Lipman, Jeffrey [1 ,2 ]
机构
[1] Univ Queensland, Burns Trauma & Crit Care Res Ctr, Brisbane, Qld, Australia
[2] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia
[3] Ghent Univ Hosp, Ghent, Belgium
[4] Attikon Univ Hosp, Athens, Greece
[5] Hosp Nord, Marseille, France
[6] Univ Paris 07, CHU Bichat Claude Bernard, AP HP, Paris, France
[7] Hosp Valle De Hebron, Barcelona, Spain
[8] St Georges Healthcare NHS Trust, London, England
[9] St Georges Univ London, London, England
基金
英国医学研究理事会;
关键词
Antibiotic; beta eta-lactam; Glycopeptide; Triazole; Echinocandin; Continuous infusion; Extended infusion; Bolus dosing; Adverse events; Pharmacokinetics; Pharmacodynamics; ACUTE-RENAL-FAILURE; SEPTIC PATIENTS; POPULATION PHARMACOKINETICS; PHARMACODYNAMICS; SEPSIS; SIMULATIONS; MEROPENEM; FLUCONAZOLE; MORTALITY; CEFEPIME;
D O I
10.1186/1471-2334-12-152
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. Methods: DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. Discussion: The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.
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页数:7
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