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Early target attainment of continuous infusion piperacillin/tazobactam and meropenem in critically ill patients: A prospective observational study.
- Source :
-
Journal of critical care [J Crit Care] 2019 Aug; Vol. 52, pp. 75-79. Date of Electronic Publication: 2019 Apr 09. - Publication Year :
- 2019
-
Abstract
- Purpose: To evaluate target attainment of empirically dosed continuous infusion piperacillin/tazobactam (TZP) and meropenem (MER) in critically ill patients.<br />Patients and Methods: Patients were sampled on a daily basis. TZP or MER concentrations were evaluated during the first two days antibiotic therapy. The lower limit of the target range was defined as unbound concentrations equaling 4 times the epidemiological cutoff value of P. aeruginosa. The upper limit of the target range was based on the risk of toxicity, i.e. unbound concentrations >160 mg/L for TZP and > 45 mg/L for MER. Multivariable logistic regression was used to evaluate factors associated with target attainment.<br />Results: Data from 253 patients were analyzed. Overall, 76/205 (37.1%) and 36/48 (75%) of the patients receiving TZP or MER respectively, attained target concentrations. In multivariable analysis, estimated creatinine clearance was identified as a risk factor for target non-attainment (OR 0.988, 95%CI [0.982;0.994]). Patients receiving MER were more likely to attain target concentrations compared with patients receiving TZP (OR 6.02, 95%CI [2.12;18.4]).<br />Conclusion: Target attainment of empiric antibiotic therapy in critically ill patients was low (37%) for TZP and moderate (75%) for MER, despite the use of a loading dose and despite optimization of the mode of infusion.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Anti-Bacterial Agents therapeutic use
Creatinine urine
Female
Humans
Kidney Function Tests
Middle Aged
Multivariate Analysis
Prospective Studies
Pseudomonas aeruginosa
Risk Factors
Treatment Outcome
Critical Illness
Meropenem administration & dosage
Piperacillin, Tazobactam Drug Combination administration & dosage
Pseudomonas Infections drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1557-8615
- Volume :
- 52
- Database :
- MEDLINE
- Journal :
- Journal of critical care
- Publication Type :
- Academic Journal
- Accession number :
- 30986758
- Full Text :
- https://doi.org/10.1016/j.jcrc.2019.04.013