| Title |
High target attainment for β-lactam antibiotics in intensive care unit patients when actual minimum inhibitory concentrations are applied
|
|---|---|
| Published in |
European Journal of Clinical Microbiology & Infectious Diseases, November 2016
|
| DOI | 10.1007/s10096-016-2832-4 |
| Pubmed ID | |
| Authors |
H. Woksepp, A. Hällgren, S. Borgström, F. Kullberg, A. Wimmerstedt, A. Oscarsson, P. Nordlund, M-L. Lindholm, J. Bonnedahl, L. Brudin, B. Carlsson, T. Schön |
| Abstract |
Patients in the intensive care unit (ICU) are at risk for suboptimal levels of β-lactam antibiotics, possibly leading to poor efficacy. Our aim was to investigate whether the actual minimum inhibitory concentration (MIC) compared to the more commonly used arbitrary epidemiological cut-off values (ECOFFs) would affect target attainment in ICU patients on empirical treatment with broad-spectrum β-lactam antibiotics and to identify risk factors for not reaching target. In a prospective, multicenter study, ICU patients ≥18 years old and treated with piperacillin/tazobactam, meropenem, or cefotaxime were included. Clinical and laboratory data were recorded. Serum trough antibiotic levels from three consecutive days were analyzed by liquid chromatography-mass spectrometry (LC-MS). The target was defined as the free trough concentration above the MIC (100% fT>MIC). MICECOFF was used as the target and, when available, the actual MIC (MICACTUAL) was applied. The median age of the patients was 70 years old, 52% (58/111) were males, and the median estimated glomerular filtration rate (eGFR) was 48.0 mL/min/1.73 m(2). The rate of patients reaching 100% fT > MICACTUAL was higher (89%, 31/35) compared to the same patients using MICECOFF (60%, p = 0.002). In total, 55% (61/111) reached 100% fT > MICECOFF. Increased renal clearance was independently associated to not reaching 100% fT > MICECOFF. On repeated sampling, >77% of patients had stable serum drug levels around the MICECOFF. Serum concentrations of β-lactam antibiotics vary extensively between ICU patients. The rate of patients not reaching target was markedly lower for the actual MIC than when the arbitrary MIC based on the ECOFF was used, which is important to consider in future studies. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 14% |
| Spain | 1 | 14% |
| South Africa | 1 | 14% |
| Unknown | 4 | 57% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 86% |
| Practitioners (doctors, other healthcare professionals) | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 29 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 17% |
| Student > Master | 4 | 14% |
| Student > Ph. D. Student | 3 | 10% |
| Student > Doctoral Student | 2 | 7% |
| Student > Postgraduate | 2 | 7% |
| Other | 6 | 21% |
| Unknown | 7 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 48% |
| Pharmacology, Toxicology and Pharmaceutical Science | 7 | 24% |
| Unknown | 8 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 July 2017.
All research outputs
#6,261,923
of 22,899,952 outputs
Outputs from European Journal of Clinical Microbiology & Infectious Diseases
#624
of 2,776 outputs
Outputs of similar age
#95,452
of 311,298 outputs
Outputs of similar age from European Journal of Clinical Microbiology & Infectious Diseases
#15
of 49 outputs
Altmetric has tracked 22,899,952 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 2,776 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one has done well, scoring higher than 77% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 311,298 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 49 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.