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The effect of renal replacement therapy and antibiotic dose on antibiotic concentrations in critically ill patients: Data from the multinational SMARRT Study.

Title: The effect of renal replacement therapy and antibiotic dose on antibiotic concentrations in critically ill patients: Data from the multinational SMARRT Study.
Authors: Roberts, Jason A; Joynt, Gavin; Lee, Anna; Choi, Gordon; Bellomo, Rinaldo; Kanji, Salmaan; Mudaliar, M Yugan; Peake, Sandra L; Stephens, Dianne; Taccone, Fabio Silvio; Ulldemolins, Marta; Valkonen, Miia Maaria; Agbeve, Julius; Baptista, João P; Bekos, Vasileios; Boidin, Clement; Brinkmann, Alexander; Buizen, Luke; Castro, Pedro; Cole, C Louise; Creteur, Jacques; De Waele, Jan J; Deans, Renae; Eastwood, Glenn M; Escobar, Leslie; Gomersall, Charles; Gresham, Rebecca; Jamal, Janattul Ain; Kluge, Stefan; König, Christina; Koulouras, Vasilios P; Lassig-Smith, Melissa; Laterre, Pierre-François; Lei, Katie; Leung, Patricia; Lefrant, Jean-Yves; Llauradó-Serra, Mireia; Martin-Loeches, Ignacio; Mat Nor, Mohd Basri; Ostermann, Marlies; Parker, Suzanne L; Rello, Jordi; Roberts, Darren M; Roberts, Michael S; Richards, Brent; Rodríguez, Alejandro; Roehr, Anka C; Roger, Claire; Seoane, Leonardo; Sinnollareddy, Mahipal; Sousa, Eduardo; Soy, Dolors; Spring, Anna; Starr, Therese; Thomas, Jane; Turnidge, John; Wallis, Steven C; Williams, Tricia; Wittebole, Xavier; Zikou, Xanthi T; Paul, Sanjoy; Lipman, Jeffrey
Contributors: UCL - SSS/IREC/MEDA - Pôle de médecine aiguë; UCL - (SLuc) Service de soins intensifs
Source: Clinical infectious diseases, Vol. 72, no. 8, p. 1369-1378 (2021)
Publisher Information: Oxford University Press
Publication Year: 2021
Collection: DIAL@USL-B (Université Saint-Louis, Bruxelles)
Subject Terms: Beta-lactam; Continuous renal replacement therapy; Extended daily dialysis; Pharmacokinetic; Renal clearance; Trough concentration
Description: BACKGROUND: The optimal dosing of antibiotics in critically ill patients receiving renal replacement therapy (RRT) remains unclear. In this study, we describe the variability in RRT techniques and antibiotic dosing in critically ill patients receiving RRT and to relate observed trough antibiotic concentrations to optimal targets. METHODS: We performed a prospective, observational, multi-national, pharmacokinetic study in 29 intensive care units from 14 countries. We collected demographic, clinical and RRT data. We measured trough antibiotic concentrations of meropenem, piperacillin-tazobactam and vancomycin and related them to high and low target trough concentrations. RESULTS: We studied 381 patients and obtained 508 trough antibiotic concentrations. There was wide variability (4-8 fold) in antibiotic dosing regimens; RRT prescription, and estimated endogenous renal function. The overall median estimated total renal clearance (eTRCL) was 50 mL/min (interquartile range [IQR] 35-65) and higher eTRCL was associated with lower trough concentrations for all antibiotics (p
Document Type: article in journal/newspaper
Language: English
Relation: boreal:241969; http://hdl.handle.net/2078.1/241969; info:pmid/32150603
DOI: 10.1093/cid/ciaa224
Availability: http://hdl.handle.net/2078.1/241969; https://doi.org/10.1093/cid/ciaa224
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.22578F16
Database: BASE