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10 results on '"Jorens, P."'

1. Recalibration of the delirium prediction model for ICU patients (PRE-DELIRIC): a multinational observational study.

Author

van den Boogaard M, Schoonhoven L, Maseda E, Plowright C, Jones C, Luetz A, Sackey PV, Jorens PG, Aitken LM, van Haren FM, Donders R, van der Hoeven JG, and Pickkers P

Subjects
APACHE, Adult, Age Factors, Aged, Area Under Curve, Calibration, Confusion diagnosis, Decision Support Techniques, Delirium epidemiology, Female, Humans, Incidence, Internationality, Length of Stay statistics & numerical data, Male, Middle Aged, Odds Ratio, Patient Admission statistics & numerical data, Prospective Studies, ROC Curve, Reproducibility of Results, Delirium diagnosis, Intensive Care Units statistics & numerical data
Abstract

Purpose: Recalibration and determining discriminative power, internationally, of the existing delirium prediction model (PRE-DELIRIC) for intensive care patients., Methods: A prospective multicenter cohort study was performed in eight intensive care units (ICUs) in six countries. The ten predictors (age, APACHE-II, urgent and admission category, infection, coma, sedation, morphine use, urea level, metabolic acidosis) were collected within 24 h after ICU admission. The confusion assessment method for the intensive care unit (CAM-ICU) was used to identify ICU delirium. CAM-ICU screening compliance and inter-rater reliability measurements were used to secure the quality of the data., Results: A total of 2,852 adult ICU patients were screened of which 1,824 (64%) were eligible for the study. Main reasons for exclusion were length of stay <1 day (19.1%) and sustained coma (4.1%). CAM-ICU compliance was mean (SD) 82 ± 16% and inter-rater reliability 0.87 ± 0.17. The median delirium incidence was 22.5% (IQR 12.8-36.6%). Although the incidence of all ten predictors differed significantly between centers, the area under the receiver operating characteristic (AUROC) curve of the eight participating centers remained good: 0.77 (95% CI 0.74-0.79). The linear predictor and intercept of the prediction rule were adjusted and resulted in improved re-calibration of the PRE-DELIRIC model., Conclusions: In this multinational study, we recalibrated the PRE-DELIRIC model. Despite differences in the incidence of predictors between the centers in the different countries, the performance of the PRE-DELIRIC-model remained good. Following validation of the PRE-DELIRIC model, it may facilitate implementation of strategies to prevent delirium and aid improvements in delirium management of ICU patients.

Published
2014
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2. Impact of a standardized nurse observation protocol including MEWS after Intensive Care Unit discharge.

Author

De Meester K, Das T, Hellemans K, Verbrugghe W, Jorens PG, Verpooten GA, and Van Bogaert P

Subjects
Aged, Female, Humans, Male, Middle Aged, Intensive Care Units, Nursing Assessment standards, Patient Discharge
Abstract

Background: Analysis of in-hospital mortality after serious adverse events (SAE's) in our hospital showed the need for more frequent observation in medical and surgical wards. We hypothesized that the incidence of SAE's could be decreased by introducing a standard nurse observation protocol., Aim: To investigate the effect of a standard nurse observation protocol implementing the Modified Early Warning Score (MEWS) and a color graphic observation chart., Methods: Pre- and post-intervention study by analysis of patients records for a 5-day period after Intensive Care Unit (ICU) discharge to 14 medical and surgical wards before (n=530) and after (n=509) the intervention., Results: For the total study population the mean Patient Observation Frequency Per Nursing Shift (POFPNS) during the 5-day period after ICU discharge increased from .9993 (95% C.I. .9637-1.0350) in the pre-intervention period to 1.0732 (95% C.I. 1.0362-1.1101) (p=.005) in the post-intervention period. There was an increased risk of a SAE in patients with MEWS 4 or higher in the present nursing shift (HR 8.25; 95% C.I. 2.88-23.62) and the previous nursing shift (HR 12.83;95% C.I. 4.45-36.99). There was an absolute risk reduction for SAE's within 120h after ICU discharge of 2.2% (95% C.I. -0.4-4.67%) from 5.7% to 3.5%., Conclusion: The intervention had a positive impact on the observation frequency. MEWS had a predictive value for SAE's in patients after ICU discharge. The drop in SAE's was substantial but did not reach statistical significance., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Published
2013
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3. Glucose control and use of continuous glucose monitoring in the intensive care unit: a critical review.

Author

De Block C, Manuel-y-Keenoy B, Rogiers P, Jorens P, and Van Gaal L

Subjects
Blood Glucose drug effects, Cardiac Surgical Procedures adverse effects, Cardiovascular Surgical Procedures adverse effects, Child, Critical Illness, Humans, Hyperglycemia blood, Hyperglycemia epidemiology, Infant, Newborn, Insulin therapeutic use, Intensive Care Units, Neonatal standards, Intensive Care Units, Neonatal statistics & numerical data, Intensive Care Units, Pediatric standards, Intensive Care Units, Pediatric statistics & numerical data, Prevalence, Stress, Physiological physiology, Blood Glucose metabolism, Hyperglycemia etiology, Intensive Care Units standards, Intensive Care Units statistics & numerical data, Monitoring, Ambulatory methods
Abstract

Stress hyperglycemia recently became a major therapeutic target in the Intensive Care Unit (ICU) since it occurs in most critically ill patients and is associated with adverse outcome, including increased mortality. Intensive insulin therapy to achieve normoglycemia may reduce mortality, morbidity and the length of ICU and in-hospital stay. However, obtaining normoglycemia requires extensive efforts from the medical staff, including frequent glucose monitoring and adjustment of insulin dose. Current insulin titration is based upon discrete glucose measurements, which may miss fast changes in glycemia and which does not give a full picture of overall glycemic control. Recent evidence suggests that continuous monitoring of glucose levels may help to signal glycemic excursions and eventually to optimize insulin titration in the ICU. In this review we will summarise monitoring and treatment strategies to achieve normoglycemia in the ICU, with special emphasis on the possible advantages of continuous glucose monitoring.

Published
2008
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4. High-dose cefepime as an alternative treatment for infections caused by TEM-24 ESBL-producing Enterobacter aerogenes in severely-ill patients.

Author

Goethaert K, Van Looveren M, Lammens C, Jansens H, Baraniak A, Gniadkowski M, Van Herck K, Jorens PG, Demey HE, Ieven M, Bossaert L, and Goossens H

Subjects
Adult, Aged, Anti-Bacterial Agents therapeutic use, Carbapenems administration & dosage, Carbapenems therapeutic use, Cefepime, Cephalosporins therapeutic use, Cross Infection drug therapy, Cross Infection microbiology, Drug Therapy, Combination, Enterobacter aerogenes drug effects, Enterobacteriaceae Infections microbiology, Female, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Retrospective Studies, Treatment Outcome, Anti-Bacterial Agents administration & dosage, Bacterial Proteins biosynthesis, Cephalosporins administration & dosage, Critical Illness, Enterobacter aerogenes enzymology, Enterobacteriaceae Infections drug therapy, Intensive Care Units, beta-Lactamases biosynthesis
Abstract

This study evaluated retrospectively the efficacy of treatment with cefepime vs. a carbapenem, in combination with amikacin or ciprofloxacin, for seriously-ill patients infected with ESBL-producing Enterobacter aerogenes who were admitted to an intensive care unit. Forty-four episodes of infection were investigated in 43 patients: 21 treated with cefepime; 23 with a carbapenem. The two treatment groups did not differ statistically in terms of age, APACHE II scores, and infection sites, but the average duration of antibiotic exposure was significantly shorter in the cefepime group (8.5 days vs. 11.4 days; p 0.04). Clinical improvement was seen in 62% of patients receiving cefepime vs. 70% of patients receiving a carbapenem (p 0.59). Bacteriological eradication was achieved in 14% of patients receiving cefepime vs. 22% of patients receiving a carbapenem (p 0.76). The 30-day mortality rates related to infection were 33% in the cefepime group and 26% in the carbapenem group (p 0.44). Thus, outcome parameters did not differ significantly between the two groups. Nevertheless, a statistically significant increase in failure to eradicate ESBL-producing E. aerogenes was observed as the MICs of cefepime rose (p 0.017). Pulsed-field gel electrophoresis revealed three distinct clones, but one predominant clone harbouring the bla(TEM-24) gene was associated with most (42/44) of the episodes of infection. It was concluded that cefepime may be an alternative agent for therapy of severe infections caused by TEM-24 ESBL-producing E. aerogenes, although further studies are required to confirm these observations.

Published
2006
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5. DALI: Defining Antibiotic Levels in Intensive Care Unit Patients: Are Current -Lactam Antibiotic Doses Sufficient for Critically Ill Patients?

Author

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, 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, and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
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
Abstract

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

Published
2014

6. Circulating phthalates during critical illness in children are associated with long-term attention deficit: a study of a development and a validation cohort.

Author

Verstraete, S., Vanhorebeek, I., Covaci, A., Güiza, F., Malarvannan, G., Jorens, P., Van den Berghe, G., and Jorens, P G

Subjects
PHYSIOLOGICAL effects of phthalate esters, ATTENTION-deficit hyperactivity disorder, CRITICALLY ill children, INTENSIVE care units, MEDICAL equipment, CATASTROPHIC illness, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, PEDIATRICS, RESEARCH, EVALUATION research, CARBOCYCLIC acids
Abstract

Purpose: Environmental phthalate exposure has been associated with attention deficit disorders in children. We hypothesized that in children treated in the pediatric intensive care unit (PICU), circulating phthalates leaching from indwelling medical devices contribute to their long-term attention deficit.Methods: Circulating plasma concentrations of di(2-ethylhexyl)phthalate (DEHP) metabolites were quantified in 100 healthy children and 449 children who had been treated in PICU and were neurocognitively tested 4 years later. In a development patient cohort (N = 228), a multivariable bootstrap study identified stable thresholds of exposure to circulating DEHP metabolites above which there was an independent association with worse neurocognitive outcome. Subsequently, in a second patient cohort (N = 221), the observed independent associations were validated.Results: Plasma concentrations of DEHP metabolites, which were virtually undetectable [0.029 (0.027-0.031) µmol/l] in healthy children, were 4.41 (3.76-5.06) µmol/l in critically ill children upon PICU admission (P < 0.001). Plasma DEHP metabolite concentrations decreased rapidly but remained 18 times higher until PICU discharge (P < 0.001). After adjusting for baseline risk factors and duration of PICU stay, and further for PICU complications and treatments, exceeding the potentially harmful threshold for exposure to circulating DEHP metabolites was independently associated with the attention deficit (all P ≤ 0.008) and impaired motor coordination (all P ≤ 0.02). The association with the attention deficit was confirmed in the validation cohort (all P ≤ 0.01). This phthalate exposure effect explained half of the attention deficit in post-PICU patients.Conclusions: Iatrogenic exposure to DEHP metabolites during intensive care was independently and robustly associated with the important attention deficit observed in children 4 years after critical illness. Clinicaltrials.gov identifier: NCT00214916. [ABSTRACT FROM AUTHOR]

Published
2016
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7. Clinical pharmacology of exogenously administered alkaline phosphatase.

Author

Pickkers, P., Snellen, F., Rogiers, P., Bakker, J., Jorens, P., Meulenbelt, J., Spapen, H., Tulleken, J. E., Lins, R., Ramael, S., Bulitta, M., and Hoeven, J. G. van der

Subjects
CLINICAL pharmacology, INTENSIVE care units, ALKALINE phosphatase, MEDICAL protocols, DRUG dosage, ENDOTOXEMIA, NATURAL immunity, INFUSION therapy
Abstract

To evaluate the clinical pharmacology of exogenous alkaline phosphatase (AP). Randomized, double-blind, placebo-controlled sequential protocols of (1) ascending doses and infusion duration (volunteers) and (2) fixed dose and duration (patients) were conducted at clinical pharmacology and intensive care units. A total of 103 subjects (67 male volunteers and 36 patients with severe sepsis) were administered exogenous, 10-min IV infusions (three ascending doses) or 24–72 h continuous (132.5–200 U kg−1 24 h−1) IV infusion with/without preceding loading dose and experimental endotoxemia for evaluations of pharmacokinetics, pharmacodynamics, safety parameters, antigenicity, inflammatory markers, and outcomes. Linearity and dose-proportionality were shown during 10-min infusions. The relatively short elimination half-life necessitated a loading dose to achieve stable enzyme levels. Pharmacokinetic parameters in volunteers and patients were similar. Innate immunity response was not significantly influenced by AP, while renal function significantly improved in sepsis patients. The pharmacokinetics of exogenous AP is linear, dose-proportional, exhibit a short half-life, and are not influenced by renal impairment or dialysis. [ABSTRACT FROM AUTHOR]

Published
2009
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8. Data-Driven Medicine: A Meaningful Use of Patient Data to Improve Process Adherence and Patient Outcome of Mechanically Ventilated Subjects.

Author

Verbrugghe, Walter and Jorens, Philippe G.

Subjects
RESPIRATORY insufficiency treatment, ARTIFICIAL respiration, INTENSIVE care units, EVIDENCE-based medicine, MECHANICAL ventilators, TREATMENT effectiveness
Abstract

The article focuses on a study which examines the effectiveness of evidence-based treatment goals for pediatric patients receiving invasive mechanical ventilation as a starting point. Topics discussed include the integration of data from connected mechanical ventilators and other equipment with the clinical data available in the electronic medical record system and the failure of clinicians to translate data into meaningful information that is relevant for the clinical context of a patient.

Published
2017
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9. Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

Author

Vogelaers, Dirk, Blot, Stijn, Van den Berge, Andries, Montravers, Philippe, Francois, Guy, Labeau, Sonia, Blot, Koen, Deschepper, Mieke, Antonelli, Massimo, Lipman, Jeffrey, Lamrous, Amin, Pereyra, Cecilia, Lipovestky, Fernando, Koulenti, Despoina, De Waele, Jan, Rezende-Neto, Joao, Cardenas, Yenny, Vymazal, Tomas, Fjeldsoee-Nielsen, Hans, Kott, Matthias, Kostoula, Arvaniti, Javeri, Yash, Girardis, Massimo, Einav, Sharon, de Lange, Dylan, Makikado, Luis Daniel Umezawa, Mikstacki, Adam, Paiva, José-Artur, Tomescu, Dana, Gritsan, Alexey, Jovanovic, Bojan, Venkatesan, Kumaresh, Mirkovic, Tomislav, Maseda, Emilio, Dikmen, Yalim, Creagh-Brown, Benedict, Emmerich, Monica, Canale, Mariana, Dietz, Lorena Silvina, Ilutovich, Santiago, Miñope, John Thomas Sanchez, Silva, Ramona Baldomera, Montenegro, Martin Alexis, Martin, Patricio, Saul, Pablo, Chediack, Viviana, Sutton, Giselle, Couce, Rocio, Balasini, Carina, Gonzalez, Susana, Lascar, Florencia Maria, Descotte, Emiliano Jorge, Gumiela, Natalia Soledad, Pino, Carina Alejandra, Cesio, Cristian, Valgolio, Emanuel, Cunto, Eleonora, Dominguez, Cecilia, Nelson, Nydia Funes, Abegao, Esteban Martin, Pozo, Norberto Christian, Bianchi, Luciana, Correger, Enrique, Pastorino, Maria Laura, Miyazaki, Erica Aurora, Grubissich, Nicolas, Garcia, Mariel, Bonetto, Natalia, Quevedo, Noelia Elizabeth, Gomez, Cristina Delia, Queti, Felipe, Estevarena, Luis Gonzalez, Fernandez, Ruben, Santolaya, Ignacio, Grangeat, Sergio Hugo, Doglia, Juan, Zakalik, Graciela, Pellegrini, Carlos, Lloria, Maria Monserrat, Chacon, Mercedes Esteban, Fumale, Mariela, Leguizamon, Mariela, Hidalgo, Irene Beatriz, Tiranti, Roberto Julian, Capponi, Paola, Tita, Agustin, Cardonnet, Luis, Bettini, Lisandro, Ramos, Agñel, Lovesio, Luciano, Miranda, Edith Miriam, Farfan, Angelica Beatriz, Tolosa, Carina, Segura, Lise, Bellocchio, Adelina, Alvarez, Brian, Manzur, Adriana, Lujan, Rodolfo, Fernandez, Natalia, Scarone, Nahuel, Zazu, Alan, Groh, Carina, Fletcher, Jason, Smith, Julie, Azad, Raman, Chavan, Nitin, Wong, Helen, Kol, Mark, Campbell, Lewis, Starr, Therese, Roberts, Brigit, Wibrow, Bradley, Warhurst, Timothy, Chinthamuneedi, Meher, Ferney, Bernal Buitrago, Simon, Marc, De Backer, Daniel, Wittebole, Xavier, De Bels, David, Collin, Vincent, Dams, Karolien, Jorens, Philippe, Dubois, Jasperina, Gunst, Jan, Haentjens, Lionel, De Schryver, Nicolas, Dugernier, Thierry, Rizoli, Sandro, Santillan, Paul, Han, Yi, Biskup, Ewelina, Qu, Changjing, Li, Xinyu, Yu, Tao, Weihua, Lu, Molano-Franco, Daniel, Rojas, José, Oviedo, Juan Mauricio Pardo, Pinilla, Dario, Celis, Edgar, Arias, Mario, Vukovic, Anita, Vudrag, Maja, Belavic, Matija, Zunic, Josip, Kuharic, Janja, Kricka, Irena Bozanic, Filipovic-Grcic, Ina, Tomasevic, Boris, Obraz, Melanija, Bodulica, Bruna, Dohnal, Martin, Malaska, Jan, Kratochvil, Milan, Satinsky, Igor, Schwarz, Peter, Kos, Zdenek, Blahut, Ladislav, Maca, Jan, Protus, Marek, Kieslichová, Eva, Nielsen, Louise Gramstrup, Krogh, Birgitte Marianne, Rivadeneira, Francisco, Morales, Freddy, Mora, José, Orozco, Alexandra Saraguro, MorochoTutillo, Diego Rolando, Vargas, Nelson Remache, Yepez, Estuardo Salgado, Villamagua, Boris, Alsisi, Adel, Fahmy, Abdelraouf, Dupont, Hervé, Lasocki, Sigismond, Paugam-Burtz, Catherine, Foucrier, Arnaud, Nica, Alexandru, Barjon, Geneviève, Mallat, Jihad, Marcotte, Guillaume, Leone, Marc, Duclos, Gary, Burtin, Philippe, Atchade, Enora, Mahjoub, Yazine, Misset, Benoît, Timsit, Jean-François, Dupuis, Claire, Veber, Benoît, Debarre, Matthieu, Collange, Oliver, Pottecher, Julien, Hecketsweiler, Stephane, Fromentin, Mélanie, Tesnière, Antoine, Koch, Christian, Sander, Michael, Eckmann, Christian, Elke, Gunnar, Wrigge, Hermann, Simon, Philipp, Chalkiadaki, Anthoula, Tzanidakis, Charalampos, Pneumatikos, Ioannis, Sertaridou, Eleni, Mastora, Zafiria, Pantazopoulos, Ioannis, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Floros, John, Kolonia, Virginia, Dimopoulos, George, Diakaki, Chryssa, Rallis, Michael, Paridou, Alexandra, Kalogeromitros, Alexandros, Romanou, Vasiliki, Nikolaou, Charikleia, Kounougeri, Katerina, Tsigou, Evdoxia, Psallida, Vasiliki, Karampela, Niki, Mandragos, Konstantinos, Kontoudaki, Eftychia, Pentheroudaki, Alexandra, Farazi-Chongouki, Christos, Karakosta, Agathi, Chouris, Isaac, Radu, Vasiliki, Malliotakis, Polychronis, Kokkini, Sofia, Charalambous, Eliana, Kyritsi, Aikaterini, Koulouras, Vasilios, Papathanakos, Georgios, Nagky, Eva, Lampiri, Clairi, Tsimpoukas, Fotios, Sarakatsanos, Ioannis, Georgakopoulos, Panagiotis, Ravani, Ifigeneia, Prekates, Athanasios, Sakellaridis, Konstantinos, Christopoulos, Christos, Vrettou, Efstratia, Stokkos, Konstantinos, Pentari, Anastasia, Arvaniti, Kostoula, Marmanidou, Kyriaki, Kydona, Christina, Tsoumaropoulos, Georgios, Bitzani, Militisa, Kontou, Paschalina, Voudouris, Antonios, Elli-Nikki, [missing], Flioni, [missing], Antypa, Elli, Chasou, Eleftheria, Anisoglou, Souzana, Papageorgiou, Eirini, Paraforou, Theoniki, Tsioka, Agoritsa, Karathanou, Antigoni, Vakalos, Aristeidis, Shah, Bhagyesh, Thakkar, Chirag, Jain, Nikhilesh, Gurjar, Mohan, Baronia, Arvind, Sathe, Prachee, Kulkarni, Shilpa, Paul, Cherish, Paul, John, Masjedi, Mansoor, Nikandish, Reza, Zand, Farid, Sabetian, Golnar, Mahmoodpoor, Ata, Hashemian, Seyed Mohammadreza, Bala, Miklosh, Flocco, Romeo, Torrente, Sergio, Pota, Vincenzo, Spadaro, Savino, Volta, Carlo, Serafini, Giulia, Boraso, Sabrina, Tiberio, Ivo, Cortegiani, Andrea, Misseri, Giovanni, Barbagallo, Maria, Nicolotti, Davide, Forfori, Francesco, Corradi, Francesco, De Pascale, Gennaro, Pelagalli, Lorella, Brazzi, Luca, Vittone, Ferdinando Giorgio, Russo, Alessandro, Simion, Davide, Cotoia, Antonella, Cinnella, Gilda, Toppin, Patrick, Johnson-Jackson, Roxanne, Hayashi, Yoshiro, Yamamoto, Ryohei, Yasuda, Hideto, Kishihara, Yuki, Shiotsuka, Junji, Sanchez-Hurtado, Luis Alejandro, Tejeda-Huezo, Brigitte, Gorordo, Luis, Ñamendys-Silva, Silvio A., Garcia-Guillen, Francisco J., Martinez, Manuel, Romero-Meja, Erick, Colorado-Dominguez, Ever, van den Oever, Huub, Kalff, Karel Martijn, Vermeijden, Wytze, Cornet, Alexander Daniel, Beck, Oliver, Cimic, Nedim, Dormans, Tom, Bormans, Laura, Bakker, Jan, Van Duijn, Ditty, Bosman, Gerrit, Vos, Piet, Haas, Lenneke, Henein, Akram, Miranda, Ariel M., Malca, Gonzalo Ernesto Gianella, Arroyo-Sanchez, Abel, Misiewska-Kaczur, Agnieszka, Akinyi, Frisch, Czuczwar, Miroslaw, Luczak, Karolina, Sulkowski, Wiktor, Tamowicz, Barbara, Swit, Beata, Baranowski, Bronisław, Smuszkiewicz, Piotr, Trojanowska, Iwona, Rzymski, Stanislaw, Sawinski, Mariusz, Trosiak, Marta, Mikaszewska-Sokolewicz, Malgorzata, Alves, Ricardo, Leal, Dina, Krystopchuk, Andriy, Mendonca, Pedro Muguel Hilario, Pereira, Rui Antunes, de Carvalho, Maria Raquel Lopes Marques, Candeias, Carlos, Molinos, Elena, Ferreira, Amélia, Castro, Guiomar, Pereira, José-Manuel, Santos, Lurdes, Ferreira, Alcina, Pascoalinho, Dulce, Ribeiro, Rosa, Domingos, Guilherme, Gomes, Pedro, Nora, David, Costa, Rui Pedro, Santos, Anabela, Alsheikhly, Ahmed Subhy, Popescu, Mihai, Grigoras, Ioana, Patrascanu, Emilia, Zabolotskikh, Igor, Musaeva, Tatiana, Gaigolnik, Denis, Kulabukhov, Vladimir, Belskiy, Vladislav, Zubareva, Nadezhda, Tribulev, Maxim, Abdelsalam, Ahmed, Aldarsani, Ayman, Al-Khalid, Muhammad, Almekhlafi, Ghaleb, Mandourah, Yasser, Doklestic, Krstina, Velickovic, Jelena, Velickovic, Dejan, Jankovic, Radmilo, Skoric-Jokic, Svetlana, Radovanovic, Dragana, Richards, Guy, Alli, Ahmad, Del Carmen Cordoba Nielfa, Maria, Iniesta, Rafael Sánchez, Martínez, Adela Benítez-Cano, Bernedo, Carlos Garcia, Gil, Santiago Alberto Picos, Nuvials, Xavier, Rello, Jordi, Garcia, Joseba Gonzalez, Peña, Jose Manuel Garcia, Jimenez, Roberto, Herrera, Luis, Barrachina, Laura Galarza, Monzon, Ignacio Catalan, Redondo, Francisco Javier, Villazala, Ruben, Zapata, Diego Fernando Matallana, Lopez, Isabel Maria Villa, Moreno-Gonzalez, Gabriel, Lopez-Delgado, Juan Carlos, Marin, Jorge Solera, Sanchez-Zamora, Purificacion, Vidal, Montserrat Vallverdú, González, Jesús Flores, Salinas, Irene, Hermosa, Cecilia, Martinez-Sagasti, Fernando, Domingo-Marín, Sara, Victorino, Johanna Abril, Garcia-Alvarez, Raquel, Calleja, Pablo López-Arcas, de la Torre-Prados, Maria-Victoria, Vidal-Cortes, Pablo, Del Río-Carbajo, Lorena, Izura, Javier, Minguez, Victoria, Alvarez, Josep Trenado, Prous, Anna Parera, Paz, Daniel, Roche-Campo, Ferran, Aguilar, Gerardo, Belda, Javier, Rico-Feijoo, Jesus, Aldecoa, Cesat, Zalba-Etayo, Begoña, Lang, Martin, Dullenkopf, Alexander, Trongtrakul, Konlawij, Chtsomkasem, Anusang, Akbaş, Türkay, Unal, Mustafa Necmettin, Ozcelik, Menekse, Gumus, Ayca, Ramazanoglu, Atilla, Memis, Dilek, Mehmet, Inal, Urkmez, Seval, Ozgultekin, Asu, Demirkiran, Oktay, Aslan, Nesrin Ahu, Kizilaslan, Deniz, Kahveci, Ferda, Ünlü, Nurdan, Ozkan, Zeynep, Kaye, Callum, Jansen, Jan, O’Neill, Orla, Nutt, Christopher, Jha, Rajeev, Hooker, Nicolas, Grecu, Irina, Petridou, Christina, Shyamsundar, Murali, McNamee, Lia, Trinder, John, Hagan, Samantha, Kelly, Catriona, Silversides, Jonathon, Groba, Casiano Barrera, Boyd, Owen, Bhowmick, Kaushik, Humphreys, Sally, Summers, Charlotte, Polgarova, Petra, Margarson, Michael, Dickens, Justin, Pearson, Suzanne, Chinery, Elaine, Hemmings, Noel, O’Kane, Sinead, Austin, Pauline, Cole, Stephen, Plowright, Catherine, Box, Roberta, Wright, Christopher, Young, Lorna, Creagh-Brown, Ben, Montague, Laura, Parker, Robert, Morton, Ben, Ostermann, Marlies, Bilinska, Julia, Rose, Bernd Oliver, Reece-Anthony, Rosie, Ryan, Christine, Hamilton, Mark, Hopkins, Philip, Wendon, Julia, Brescia, Giovanni, Ijaz, Nazia, Wood, James, George, Michelle, Toth-Tarsoly, Piroska, Yates, Bryan, Armstrong, Maureen, Scott, Carmen, Boyd, Christine, Szakmany, Tamas, Rees, David, Pulak, Paul, Coggon, Mandy, Saha, Bhaskar, Kent, Linda, Gibson, Bethan, Camsooksai, Julie, Reschreiter, Henrik, Morgan, Pat, Sangaralingham, Sivatharshini, Lowe, Alastair, Vondras, Petr, Jamadarkhana, Sunil, Cruz, Carina, Bhandary, Rakesh, Hersey, Peter, Furneval, Julie, Innes, Richard, Doble, Patricia, Attwood, Ben, Parsons, Penny, Page, Valerie, Zhao, Xiaobei, Dalton, Julian, Hegazy, Mohammed, Awad, Yasser, Naylor, Douglas, Naylor, Amanda, Lee, Sarah, Brevard, Sidney, Davis, Noelle, for the Abdominal Sepsis Study (‘AbSeS’) Group on behalf of the Trials Group of the European Society of Intensive Care Medicine, [missing], Vogelaers D., Blot S., Van den Berge A., Montravers P., Francois G., Labeau S., Blot K., Deschepper M., Antonelli M., Lipman J., Lamrous A., Pereyra C., Lipovestky F., Koulenti D., De Waele J., Rezende-Neto J., Cardenas Y., Vymazal T., Fjeldsoee-Nielsen H., Kott M., Kostoula A., Javeri Y., Girardis M., Einav S., de Lange D., Makikado L.D.U., Mikstacki A., Paiva J.-A., Tomescu D., Gritsan A., Jovanovic B., Venkatesan K., Mirkovic T., Maseda E., Dikmen Y., Creagh-Brown B., Emmerich M., Canale M., Dietz L.S., Ilutovich S., Minope J.T.S., Silva R.B., Montenegro M.A., Martin P., Saul P., Chediack V., Sutton G., Couce R., Balasini C., Gonzalez S., Lascar F.M., Descotte E.J., Gumiela N.S., Pino C.A., Cesio C., Valgolio E., Cunto E., Dominguez C., Nelson N.F., Abegao E.M., Pozo N.C., Bianchi L., Correger E., Pastorino M.L., Miyazaki E.A., Grubissich N., Garcia M., Bonetto N., Quevedo N.E., Gomez C.D., Queti F., Estevarena L.G., Fernandez R., Santolaya I., Grangeat S.H., Doglia J., Zakalik G., Pellegrini C., Lloria M.M., Chacon M.E., Fumale M., Leguizamon M., Hidalgo I.B., Tiranti R.J., Capponi P., Tita A., Cardonnet L., Bettini L., Ramos A., Lovesio L., Miranda E.M., Farfan A.B., Tolosa C., Segura L., Bellocchio A., Alvarez B., Manzur A., Lujan R., Fernandez N., Scarone N., Zazu A., Groh C., Fletcher J., Smith J., Azad R., Chavan N., Wong H., Kol M., Campbell L., Starr T., Roberts B., Wibrow B., Warhurst T., Chinthamuneedi M., Ferney B.B., Simon M., De Backer D., Wittebole X., De Bels D., Collin V., Dams K., Jorens P., Dubois J., Gunst J., Haentjens L., De Schryver N., Dugernier T., Rizoli S., Santillan P., Han Y., Biskup E., Qu C., Li X., Yu T., Weihua L., Molano-Franco D., Rojas J., Oviedo J.M.P., Pinilla D., Celis E., Arias M., Vukovic A., Vudrag M., Belavic M., Zunic J., Kuharic J., Kricka I.B., Filipovic-Grcic I., Tomasevic B., Obraz M., Bodulica B., Dohnal M., Malaska J., Kratochvil M., Satinsky I., Schwarz P., Kos Z., Blahut L., Maca J., Protus M., Kieslichova E., Nielsen L.G., Krogh B.M., Rivadeneira F., Morales F., Mora J., Orozco A.S., MorochoTutillo D.R., Vargas N.R., Yepez E.S., Villamagua B., Alsisi A., Fahmy A., Dupont H., Lasocki S., Paugam-Burtz C., Foucrier A., Nica A., Barjon G., Mallat J., Marcotte G., Leone M., Duclos G., Burtin P., Atchade E., Mahjoub Y., Misset B., Timsit J.-F., Dupuis C., Veber B., Debarre M., Collange O., Pottecher J., Hecketsweiler S., Fromentin M., Tesniere A., Koch C., Sander M., Eckmann C., Elke G., Wrigge H., Simon P., Chalkiadaki A., Tzanidakis C., Pneumatikos I., Sertaridou E., Mastora Z., Pantazopoulos I., Papanikolaou M., Papavasilopoulou T., Floros J., Kolonia V., Dimopoulos G., Diakaki C., Rallis M., Paridou A., Kalogeromitros A., Romanou V., Nikolaou C., Kounougeri K., Tsigou E., Psallida V., Karampela N., Mandragos K., Kontoudaki E., Pentheroudaki A., Farazi-Chongouki C., Karakosta A., Chouris I., Radu V., Malliotakis P., Kokkini S., Charalambous E., Kyritsi A., Koulouras V., Papathanakos G., Nagky E., Lampiri C., Tsimpoukas F., Sarakatsanos I., Georgakopoulos P., Ravani I., Prekates A., Sakellaridis K., Christopoulos C., Vrettou E., Stokkos K., Pentari A., Arvaniti K., Marmanidou K., Kydona C., Tsoumaropoulos G., Bitzani M., Kontou P., Voudouris A., Elli-Nikki, Flioni, Antypa E., Chasou E., Anisoglou S., Papageorgiou E., Paraforou T., Tsioka A., Karathanou A., Vakalos A., Shah B., Thakkar C., Jain N., Gurjar M., Baronia A., Sathe P., Kulkarni S., Paul C., Paul J., Masjedi M., Nikandish R., Zand F., Sabetian G., Mahmoodpoor A., Hashemian S.M., Bala M., Flocco R., Torrente S., Pota V., Spadaro S., Volta C., Serafini G., Boraso S., Tiberio I., Cortegiani A., Misseri G., Barbagallo M., Nicolotti D., Forfori F., Corradi F., De Pascale G., Pelagalli L., Brazzi L., Vittone F.G., Russo A., Simion D., Cotoia A., Cinnella G., Toppin P., Johnson-Jackson R., Hayashi Y., Yamamoto R., Yasuda H., Kishihara Y., Shiotsuka J., Sanchez-Hurtado L.A., Tejeda-Huezo B., Gorordo L., Namendys-Silva S.A., Garcia-Guillen F.J., Martinez M., Romero-Meja E., Colorado-Dominguez E., van den Oever H., Kalff K.M., Vermeijden W., Cornet A.D., Beck O., Cimic N., Dormans T., Bormans L., Bakker J., Van Duijn D., Bosman G., Vos P., Haas L., Henein A., Miranda A.M., Malca G.E.G., Arroyo-Sanchez A., Misiewska-Kaczur A., Akinyi F., Czuczwar M., Luczak K., Sulkowski W., Tamowicz B., Swit B., Baranowski B., Smuszkiewicz P., Trojanowska I., Rzymski S., Sawinski M., Trosiak M., Mikaszewska-Sokolewicz M., Alves R., Leal D., Krystopchuk A., Mendonca P.M.H., Pereira R.A., de Carvalho M.R.L.M., Candeias C., Molinos E., Ferreira A., Castro G., Pereira J.-M., Santos L., Pascoalinho D., Ribeiro R., Domingos G., Gomes P., Nora D., Costa R.P., Santos A., Alsheikhly A.S., Popescu M., Grigoras I., Patrascanu E., Zabolotskikh I., Musaeva T., Gaigolnik D., Kulabukhov V., Belskiy V., Zubareva N., Tribulev M., Abdelsalam A., Aldarsani A., Al-Khalid M., Almekhlafi G., Mandourah Y., Doklestic K., Velickovic J., Velickovic D., Jankovic R., Skoric-Jokic S., Radovanovic D., Richards G., Alli A., Del Carmen Cordoba Nielfa M., Iniesta R.S., Martinez A.B.-C., Bernedo C.G., Gil S.A.P., Nuvials X., Rello J., Garcia J.G., Pena J.M.G., Jimenez R., Herrera L., Barrachina L.G., Monzon I.C., Redondo F.J., Villazala R., Zapata D.F.M., Lopez I.M.V., Moreno-Gonzalez G., Lopez-Delgado J.C., Marin J.S., Sanchez-Zamora P., Vidal M.V., Gonzalez J.F., Salinas I., Hermosa C., Martinez-Sagasti F., Domingo-Marin S., Victorino J.A., Garcia-Alvarez R., Calleja P.L.-A., de la Torre-Prados M.-V., Vidal-Cortes P., Del Rio-Carbajo L., Izura J., Minguez V., Alvarez J.T., Prous A.P., Paz D., Roche-Campo F., Aguilar G., Belda J., Rico-Feijoo J., Aldecoa C., Zalba-Etayo B., Lang M., Dullenkopf A., Trongtrakul K., Chtsomkasem A., Akbas T., Unal M.N., Ozcelik M., Gumus A., Ramazanoglu A., Memis D., Mehmet I., Urkmez S., Ozgultekin A., Demirkiran O., Aslan N.A., Kizilaslan D., Kahveci F., Unlu N., Ozkan Z., Kaye C., Jansen J., O'Neill O., Nutt C., Jha R., Hooker N., Grecu I., Petridou C., Shyamsundar M., McNamee L., Trinder J., Hagan S., Kelly C., Silversides J., Groba C.B., Boyd O., Bhowmick K., Humphreys S., Summers C., Polgarova P., Margarson M., Dickens J., Pearson S., Chinery E., Hemmings N., O'Kane S., Austin P., Cole S., Plowright C., Box R., Wright C., Young L., Montague L., Parker R., Morton B., Ostermann M., Bilinska J., Rose B.O., Reece-Anthony R., Ryan C., Hamilton M., Hopkins P., Wendon J., Brescia G., Ijaz N., Wood J., George M., Toth-Tarsoly P., Yates B., Armstrong M., Scott C., Boyd C., Szakmany T., Rees D., Pulak P., Coggon M., Saha B., Kent L., Gibson B., Camsooksai J., Reschreiter H., Morgan P., Sangaralingham S., Lowe A., Vondras P., Jamadarkhana S., Cruz C., Bhandary R., Hersey P., Furneval J., Innes R., Doble P., Attwood B., Parsons P., Page V., Zhao X., Dalton J., Hegazy M., Awad Y., Naylor D., Naylor A., Lee S., Brevard S., Davis N., UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Vogelaers, D., Blot, S., Van den Berge, A., Montravers, P., Francois, G., Labeau, S., Blot, K., Deschepper, M., Antonelli, M., Lipman, J., Lamrous, A., Pereyra, C., Lipovestky, F., Koulenti, D., De Waele, J., Rezende-Neto, J., Cardenas, Y., Vymazal, T., Fjeldsoee-Nielsen, H., Kott, M., Kostoula, A., Javeri, Y., Girardis, M., Einav, S., de Lange, D., Makikado, L. D. U., Mikstacki, A., Paiva, J. -A., Tomescu, D., Gritsan, A., Jovanovic, B., Venkatesan, K., Mirkovic, T., Maseda, E., Dikmen, Y., Creagh-Brown, B., Emmerich, M., Canale, M., Dietz, L. S., Ilutovich, S., Minope, J. T. S., Silva, R. B., Montenegro, M. A., Martin, P., Saul, P., Chediack, V., Sutton, G., Couce, R., Balasini, C., Gonzalez, S., Lascar, F. M., Descotte, E. J., Gumiela, N. S., Pino, C. A., Cesio, C., Valgolio, E., Cunto, E., Dominguez, C., Nelson, N. F., Abegao, E. M., Pozo, N. C., Bianchi, L., Correger, E., Pastorino, M. L., Miyazaki, E. A., Grubissich, N., Garcia, M., Bonetto, N., Quevedo, N. E., Gomez, C. D., Queti, F., Estevarena, L. G., Fernandez, R., Santolaya, I., Grangeat, S. H., Doglia, J., Zakalik, G., Pellegrini, C., Lloria, M. M., Chacon, M. E., Fumale, M., Leguizamon, M., Hidalgo, I. B., Tiranti, R. J., Capponi, P., Tita, A., Cardonnet, L., Bettini, L., Ramos, A., Lovesio, L., Miranda, E. M., Farfan, A. B., Tolosa, C., Segura, L., Bellocchio, A., Alvarez, B., Manzur, A., Lujan, R., Fernandez, N., Scarone, N., Zazu, A., Groh, C., Fletcher, J., Smith, J., Azad, R., Chavan, N., Wong, H., Kol, M., Campbell, L., Starr, T., Roberts, B., Wibrow, B., Warhurst, T., Chinthamuneedi, M., Ferney, B. B., Simon, M., De Backer, D., Wittebole, X., De Bels, D., Collin, V., Dams, K., Jorens, P., Dubois, J., Gunst, J., Haentjens, L., De Schryver, N., Dugernier, T., Rizoli, S., Santillan, P., Han, Y., Biskup, E., Qu, C., Li, X., Yu, T., Weihua, L., Molano-Franco, D., Rojas, J., Oviedo, J. M. P., Pinilla, D., Celis, E., Arias, M., Vukovic, A., Vudrag, M., Belavic, M., Zunic, J., Kuharic, J., Kricka, I. B., Filipovic-Grcic, I., Tomasevic, B., Obraz, M., Bodulica, B., Dohnal, M., Malaska, J., Kratochvil, M., Satinsky, I., Schwarz, P., Kos, Z., Blahut, L., Maca, J., Protus, M., Kieslichova, E., Nielsen, L. G., Krogh, B. M., Rivadeneira, F., Morales, F., Mora, J., Orozco, A. S., Morochotutillo, D. R., Vargas, N. R., Yepez, E. S., Villamagua, B., Alsisi, A., Fahmy, A., Dupont, H., Lasocki, S., Paugam-Burtz, C., Foucrier, A., Nica, A., Barjon, G., Mallat, J., Marcotte, G., Leone, M., Duclos, G., Burtin, P., Atchade, E., Mahjoub, Y., Misset, B., Timsit, J. -F., Dupuis, C., Veber, B., Debarre, M., Collange, O., Pottecher, J., Hecketsweiler, S., Fromentin, M., Tesniere, A., Koch, C., Sander, M., Eckmann, C., Elke, G., Wrigge, H., Simon, P., Chalkiadaki, A., Tzanidakis, C., Pneumatikos, I., Sertaridou, E., Mastora, Z., Pantazopoulos, I., Papanikolaou, M., Papavasilopoulou, T., Floros, J., Kolonia, V., Dimopoulos, G., Diakaki, C., Rallis, M., Paridou, A., Kalogeromitros, A., Romanou, V., Nikolaou, C., Kounougeri, K., Tsigou, E., Psallida, V., Karampela, N., Mandragos, K., Kontoudaki, E., Pentheroudaki, A., Farazi-Chongouki, C., Karakosta, A., Chouris, I., Radu, V., Malliotakis, P., Kokkini, S., Charalambous, E., Kyritsi, A., Koulouras, V., Papathanakos, G., Nagky, E., Lampiri, C., Tsimpoukas, F., Sarakatsanos, I., Georgakopoulos, P., Ravani, I., Prekates, A., Sakellaridis, K., Christopoulos, C., Vrettou, E., Stokkos, K., Pentari, A., Arvaniti, K., Marmanidou, K., Kydona, C., Tsoumaropoulos, G., Bitzani, M., Kontou, P., Voudouris, A., Elli-Nikki, Flioni, Antypa, E., Chasou, E., Anisoglou, S., Papageorgiou, E., Paraforou, T., Tsioka, A., Karathanou, A., Vakalos, A., Shah, B., Thakkar, C., Jain, N., Gurjar, M., Baronia, A., Sathe, P., Kulkarni, S., Paul, C., Paul, J., Masjedi, M., Nikandish, R., Zand, F., Sabetian, G., Mahmoodpoor, A., Hashemian, S. M., Bala, M., Flocco, R., Torrente, S., Pota, V., Spadaro, S., Volta, C., Serafini, G., Boraso, S., Tiberio, I., Cortegiani, A., Misseri, G., Barbagallo, M., Nicolotti, D., Forfori, F., Corradi, F., De Pascale, G., Pelagalli, L., Brazzi, L., Vittone, F. G., Russo, A., Simion, D., Cotoia, A., Cinnella, G., Toppin, P., Johnson-Jackson, R., Hayashi, Y., Yamamoto, R., Yasuda, H., Kishihara, Y., Shiotsuka, J., Sanchez-Hurtado, L. A., Tejeda-Huezo, B., Gorordo, L., Namendys-Silva, S. A., Garcia-Guillen, F. J., Martinez, M., Romero-Meja, E., Colorado-Dominguez, E., van den Oever, H., Kalff, K. M., Vermeijden, W., Cornet, A. D., Beck, O., Cimic, N., Dormans, T., Bormans, L., Bakker, J., Van Duijn, D., Bosman, G., Vos, P., Haas, L., Henein, A., Miranda, A. M., Malca, G. E. G., Arroyo-Sanchez, A., Misiewska-Kaczur, A., Akinyi, F., Czuczwar, M., Luczak, K., Sulkowski, W., Tamowicz, B., Swit, B., Baranowski, B., Smuszkiewicz, P., Trojanowska, I., Rzymski, S., Sawinski, M., Trosiak, M., Mikaszewska-Sokolewicz, M., Alves, R., Leal, D., Krystopchuk, A., Mendonca, P. M. H., Pereira, R. A., de Carvalho, M. R. L. M., Candeias, C., Molinos, E., Ferreira, A., Castro, G., Pereira, J. -M., Santos, L., Pascoalinho, D., Ribeiro, R., Domingos, G., Gomes, P., Nora, D., Costa, R. P., Santos, A., Alsheikhly, A. S., Popescu, M., Grigoras, I., Patrascanu, E., Zabolotskikh, I., Musaeva, T., Gaigolnik, D., Kulabukhov, V., Belskiy, V., Zubareva, N., Tribulev, M., Abdelsalam, A., Aldarsani, A., Al-Khalid, M., Almekhlafi, G., Mandourah, Y., Doklestic, K., Velickovic, J., Velickovic, D., Jankovic, R., Skoric-Jokic, S., Radovanovic, D., Richards, G., Alli, A., Del Carmen Cordoba Nielfa, M., Iniesta, R. S., Martinez, A. B. -C., Bernedo, C. G., Gil, S. A. P., Nuvials, X., Rello, J., Garcia, J. G., Pena, J. M. G., Jimenez, R., Herrera, L., Barrachina, L. G., Monzon, I. C., Redondo, F. J., Villazala, R., Zapata, D. F. M., Lopez, I. M. V., Moreno-Gonzalez, G., Lopez-Delgado, J. C., Marin, J. S., Sanchez-Zamora, P., Vidal, M. V., Gonzalez, J. F., Salinas, I., Hermosa, C., Martinez-Sagasti, F., Domingo-Marin, S., Victorino, J. A., Garcia-Alvarez, R., Calleja, P. L. -A., de la Torre-Prados, M. -V., Vidal-Cortes, P., Del Rio-Carbajo, L., Izura, J., Minguez, V., Alvarez, J. T., Prous, A. P., Paz, D., Roche-Campo, F., Aguilar, G., Belda, J., Rico-Feijoo, J., Aldecoa, C., Zalba-Etayo, B., Lang, M., Dullenkopf, A., Trongtrakul, K., Chtsomkasem, A., Akbas, T., Unal, M. N., Ozcelik, M., Gumus, A., Ramazanoglu, A., Memis, D., Mehmet, I., Urkmez, S., Ozgultekin, A., Demirkiran, O., Aslan, N. A., Kizilaslan, D., Kahveci, F., Unlu, N., Ozkan, Z., Kaye, C., Jansen, J., O'Neill, O., Nutt, C., Jha, R., Hooker, N., Grecu, I., Petridou, C., Shyamsundar, M., Mcnamee, L., Trinder, J., Hagan, S., Kelly, C., Silversides, J., Groba, C. B., Boyd, O., Bhowmick, K., Humphreys, S., Summers, C., Polgarova, P., Margarson, M., Dickens, J., Pearson, S., Chinery, E., Hemmings, N., O'Kane, S., Austin, P., Cole, S., Plowright, C., Box, R., Wright, C., Young, L., Montague, L., Parker, R., Morton, B., Ostermann, M., Bilinska, J., Rose, B. O., Reece-Anthony, R., Ryan, C., Hamilton, M., Hopkins, P., Wendon, J., Brescia, G., Ijaz, N., Wood, J., George, M., Toth-Tarsoly, P., Yates, B., Armstrong, M., Scott, C., Boyd, C., Szakmany, T., Rees, D., Pulak, P., Coggon, M., Saha, B., Kent, L., Gibson, B., Camsooksai, J., Reschreiter, H., Morgan, P., Sangaralingham, S., Lowe, A., Vondras, P., Jamadarkhana, S., Cruz, C., Bhandary, R., Hersey, P., Furneval, J., Innes, R., Doble, P., Attwood, B., Parsons, P., Page, V., Zhao, X., Dalton, J., Hegazy, M., Awad, Y., Naylor, D., Naylor, A., Lee, S., Brevard, S., and Davis, N.

Subjects
Drug Resistance, medicine.disease_cause, Severity of Illness Index, law.invention, 0302 clinical medicine, ENTEROBACTERIACEAE, law, Drug Resistance, Multiple, Bacterial, Medicine and Health Sciences, Pharmacology (medical), Cross Infection, biology, Bacterial, Antimicrobial, Intensive care unit, Anti-Bacterial Agents, Community-Acquired Infections, Europe, Intensive Care Units, Critical Illness, Humans, Intraabdominal Infections, Microbial Sensitivity Tests, Peritonitis, Sepsis, ESCHERICHIA-COLI, 030220 oncology & carcinogenesis, KLEBSIELLA-PNEUMONIAE, BLOOD-STREAM INFECTIONS, PYELONEPHRITIS, Multiple, medicine.medical_specialty, Enterococcus faecalis, NO, 03 medical and health sciences, Intra‑abdominal Infections, Antibiotic resistance, FOOD, Intensive care, Internal medicine, medicine, FLUOROQUINOLONE RESISTANCE, Pseudomonas aeruginosa, business.industry, Septic shock, MORTALITY, biology.organism_classification, medicine.disease, RISK-FACTORS, business, 030217 neurology & neurosurgery, Enterococcus faecium
Abstract

Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.

Published
2021

10. Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Author

Abdul-Aziz, Mohd H., Lipman, Jeffrey, Akova, Murat, Bassetti, Matteo, De Waele, Jan J., Dimopoulos, George, Dulhunty, Joel, Kaukonen, Kirsi-Maija, Koulenti, Despoina, Martin, Claude, Montravers, Philippe, Rello, Jordi, Rhodes, Andrew, Starr, Therese, Wallis, Steven C., Roberts, Jason A., Paul, Sanjoy, Ribas, Antonio Margarit, De Crop, Luc, Spapen, Herbert, Wauters, Joost, Dugernier, Thierry, Jorens, Philippe, Dapper, Ilse, De Backer, Daniel, Taccone, Fabio S., Ruano, Laura, Afonso, Elsa, Alvarez-Lerma, Francisco, Gracia-Arnillas, Maria Pilar, Fernández, Francisco, Feijoo, Neus, Bardolet, Neus, Rovira, Assumpta, Garro, Pau, Colon, Diana, Castillo, Carlos, Fernado, Juan, Lopez, Maria Jesus, Fernandez, Jose Luis, Arribas, Ana Maria, Teja, Jose Luis, Ots, Elsa, Montejo, Juan Carlos, Catalan, Mercedes, Prieto, Isidro, Gonzalo, Gloria, Galvan, Beatriz, Blasco, Miguel Angel, Meyer, Estibaliz, Nogal, Frutos Del, Vidaur, Loreto, Sebastian, Rosa, Garde, Pila Marco, Velasco, Maria del Mar Martin, Crespo, Rafael Zaragoza, Esperatti, Mariano, Torres, Antoni, Baldesi, Olivier, Dupont, Herve, Mahjoub, Yazine, Lasocki, Sigismond, Constantin, Jean Michel, Payen, Jean François, Albanese, Jacques, Malledant, Yannick, Pottecher, Julien, Lefrant, Jean-Yves, Jaber, Samir, Joannes-Boyau, Olivier, Orban, Christophe, Ostermann, Marlies, Mckenzie, Catherine, Berry, Willaim, Smith, John, Lei, Katie, Rubulotta, Francesca, Gordon, Anthony, Brett, Stephen, Stotz, Martin, Templeton, Maie, Ebm, Claudia, Moran, Carl, Pettilä, Ville, Xristodoulou, Aglaia, Theodorou, Vassiliki, Kouliatsis, Georgios, Sertaridou, Eleni, Anthopoulos, Georgios, Choutas, George, Rantis, Thanos, Karatzas, Stylianos, Balla, Margarita, Papanikolaou, Metaxia, Myrianthefs, Pavlos, Gavala, Alexandra, Fildisis, Georgios, Koutsoukou, Antonia, Kyriakopoulou, Magdalini, Petrochilou, Kalomoira, Kompoti, Maria, Michalia, Martha, Clouva-Molyvdas, Fillis-Maria, Gkiokas, Georgios, Nikolakopoulos, Fotios, Psychogiou, Vasiliki, Malliotakis, Polychronis, Akoumianaki, Evangelia, Lilitsis, Emmanouil, Koulouras, Vassilios, Nakos, George, Kalogirou, Mihalis, Komnos, Apostolos, Zafeiridis, Tilemachos, Chaintoutis, Christos, Arvaniti, Kostoula, Matamis, Dimitrios, Kydona, Christina, Gritsi-Gerogianni, Nikoleta, Giasnetsova, Tatiana, Giannakou, Maria, Soultati, Ioanna, Chytas, Ilias, Antoniadou, Eleni, Antipa, Elli, Lathyris, Dimitrios, Koukoubani, Triantafyllia, Paraforou, Theoniki, Spiropoulou, Kyriaki, Bekos, Vasileios, Spring, Anna, Kalatzi, Theodora, Nikolaou, Hara, Laskou, Maria, Strouvalis, Ioannis, Aloizos, Stavros, Kapogiannis, Spyridon, Soldatou, Ourania, Adembri, Chiara, Villa, Gianluca, Giarratano, Antonio, Raineri, Santi Maurizio, Cortegiani, Andrea, Montalto, Francesca, Strano, Maria Teresa, Marco Ranieri, V., Sandroni, Claudio, De Pascale, Gennaro, Molin, Alexandre, Pelosi, Paolo, Montagnani, Luca, Urbino, Rosario, Mastromauro, Ilaria, De Rosa, Francesco G., Cardoso, Teresa, Afonso, Susana, Gonçalves-Pereira, João, Baptista, João Pedro, Özveren, Arife, Abdul-Aziz, M.H., Lipman, J., Akova, M., Bassetti, M., De Waele, J.J., Dimopoulos, G., Dulhunty, J., Kaukonen, K.-M., Koulenti, D., Martin, C., Montravers, P., Rello, J., Rhodes, A., Starr, T., Wallis, S.C., Roberts, J.A., Paul, S., Ribas, A.M., De Crop, L.D., Spapen, H., Wauters, J., Dugernier, T., Jorens, P., Dapper, I., De Backer, D.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., Montejo, J.C., Catalan, M., Prieto, I., Gonzalo, G., Galvan, B., Blasco, M.A., Meyer, E., Nogal, F.D., Vidaur, L., Sebastian, R., Garde, P.M., Velasco, M.M.M., Crespo, R.Z., Esperatti, M., Torres, A., Baldesi, O., Dupont, H., Mahjoub, Y., Lasocki, S., Constantin, J.M., Payen, J.C., 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., Raineri, S.M., Cortegiani, A., Montalto, F., Strano, M.T., Marco Ranieri, V., Sandroni, C., De Pascale, G.D., 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., University of Queensland [Brisbane], Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Service d'anesthésie - réanimation chirurgicale [CHU Bichat], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Abdul-Aziz M.H., Lipman J., Akova M., Bassetti M., De Waele J.J., Dimopoulos G., Dulhunty J., Kaukonen K.-M., Koulenti D., Martin C., Montravers P., Rello J., Rhodes A., Starr T., Wallis S.C., Roberts J.A., Paul S., Ribas A.M., De Crop L.D., Spapen H., Wauters J., Dugernier T., Jorens P., Dapper I., De Backer D.D., Taccone F.S., Ruano L., Afonso E., Alvarez-Lerma F., Gracia-Arnillas M.P., Fernandez 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., Montejo J.C., Catalan M., Prieto I., Gonzalo G., Galvan B., Blasco M.A., Meyer E., Nogal F.D., Vidaur L., Sebastian R., Garde P.M., Velasco M.M.M., Crespo R.Z., Esperatti M., Torres A., Baldesi O., Dupont H., Mahjoub Y., Lasocki S., Constantin J.M., Payen J.C., 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., Pettila 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., Raineri S.M., Cortegiani A., Montalto F., Strano M.T., Marco Ranieri V., Sandroni C., De Pascale G.D., Molin A., Pelosi P., Montagnani L., Urbino R., Mastromauro I., De Rosa F.G., Cardoso T., Afonso S., Goncalves-Pereira J., Baptista J.P., Ozveren A., Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)

Subjects
0301 basic medicine, Male, Penicillanic Acid, intensive care unit, law.invention, thienamycin derivative, abdominal infection, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, law, central nervous system infection, creatinine clearance, Pharmacology (medical), Infusions, Intravenou, Prospective Studies, Infusions, Intravenous, Prospective cohort study, Tazobactam Drug Combination, Aged, Anti-Bacterial Agents, Blood Chemical Analysis, Critical Illness, Female, Humans, Intensive Care Units, Meropenem, Microbial Sensitivity Tests, Middle Aged, Piperacillin, Piperacillin, Tazobactam Drug Combination, Thienamycins, Treatment Outcome, Pharmacology, Microbiology (medical), Infectious Diseases, critical illne, Microbial Sensitivity Test, adult, Respiratory infection, clinical trial, continuous infusion, analogs and derivative, Intensive care unit, 3. Good health, antiinfective agent, intravenous drug administration, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Piperacillin/tazobactam, multicenter study (topic), SOFA score, treatment outcome, Aged, Intravenous, prospective study, Human, medicine.drug, survival rate, medicine.medical_specialty, Infusions, post hoc analysi, respiratory tract infection, 030106 microbiology, bloodstream infection, minimum inhibitory concentration, piperacillin plus tazobactam, Tazobactam, Article, 03 medical and health sciences, critically ill patient, Internal medicine, Anti-Bacterial Agent, medicine, Sequential Organ Failure Assessment Score, Thienamycin, survival time, blood analysi, business.industry, Blood Chemical Analysi, major clinical study, Surgery, Prospective Studie, multicenter study, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, piperacillin, tazobactam drug combination, urinary tract infection, business
Abstract

Objectives: We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged- infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies. Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries. Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT≥MIC (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving β-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of ≥ 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025]. Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Published
2016

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