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Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II…

Overview of attention for article published in International Journal of Antimicrobial Agents, March 2017
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Title
Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial
Published in
International Journal of Antimicrobial Agents, March 2017
DOI 10.1016/j.ijantimicag.2016.12.022
Pubmed ID
Authors

Andrew A. Udy, Joel M. Dulhunty, Jason A. Roberts, Joshua S. Davis, Steven A.R. Webb, Rinaldo Bellomo, Charles Gomersall, Charudatt Shirwadkar, Glenn M. Eastwood, John Myburgh, David L. Paterson, Therese Starr, Sanjoy K. Paul, Jeffrey Lipman, Rinaldo Bellomo, Glenn Eastwood, Leah Peck, Helen Young, Catherine Boschert, Jason Fletcher, Julie Smith, Kiran Nand, Treena Sara, Charudatt Shirwadkar, Amy Harney, Helen Rodgers, Frank Van Haren, Sally Clarke, David Durham, Catherine Hannan, Elisha Matheson, Kate Schwartz, Karen Thomas, Allison Bone, Claire Cattigan, Tania Elderkin, Tania Salerno, Robert Cameron, Katrina Ellis, Sheridan Hatter, Joshua Davis, Milind Sanap, Natalie Soar, Josette Wood, Karen Chan, Aaron Heffernan, Nai An Lai, Catherine Moss, Kate Sheehy, Maree Duroux, Megan Ratcliffe, Samantha Shone, Timothy Warhurst, Joel Dulhunty, Rachel Dunlop, Jeffrey Lipman, David Paterson, Jason Roberts, Therese Starr, Janine Stuart, Andrew Udy, David Cooper, Rick McAllister, Steve Webb, Andrew Cheng, Deborah Inskip, Jennene Miller, John Myburgh, Serena Knowles, Claire Reynolds, Sam Rudham, Stuart Baker, Kristy Hepburn, Brigit Roberts, Paul Woods, Indranil Chatterjee, Judy Smith, Martin Cullen, Jing Kong, Vineet Nayyar, Christina Whitehead, Charles Gomersall, Patricia Leung, Eileen Gilder, Lianne McCarthy, Shay McGuiness, Rachael Parke, Kirsten Benefield, Yan Chen, Colin McArthur, Lynette Newby, Seton Henderson, Jan Mehrtens, Sascha Noble, Lesley Chadwick, Ross Freebain, Chantal Hogan, Alex Kazemi, Laura Rust, Rima Song, Anna Tilsley, Anthony Williams, John Durning, Robert Frengley, Mary La Pine, Geoff McCracken, Swarna Baskar Sharma, Lynn Andrews, Richard Dinsdale, Anna Hunt, Sally Hurford, Diane Mackle, Jessica Ongley, Paul Young, Jeffrey Lipman, Rinaldo Bellomo, Joshua Davis, Joel Dulhunty, Glenn Eastwood, Charles Gomersall, John Myburgh, David Paterson, Jason Roberts, Charudatt Shirwadkar, Therese Starr, Steve Webb, Marin Kollef, John Turnidge, Sanjoy Paul

Abstract

Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded. Primary outcome was alive ICU-free days at Day 28. Secondary outcomes included 90-day mortality and clinical cure at 14 days following antibiotic cessation. A total of 254 patients were included, among which 45 (17.7%) manifested ARC [median (IQR) CLCr 165 (144-198) mL/min]. ARC patients were younger (P < 0.001), more commonly male (P = 0.04) and had less organ dysfunction (P < 0.001). There was no difference in ICU-free days at Day 28 [ARC, 21 (12-24) days; no ARC, 21 (11-25) days; P = 0.89], although clinical cure was significantly greater in the unadjusted analysis in those manifesting ARC [33/45 (73.3%) vs. 115/209 (55.0%) P = 0.02]. This was attenuated in the multivariable analysis. No difference was noted in 90-day mortality. There were no statistically significant differences in clinical outcomes in ARC patients according to the dosing strategy employed. In this substudy of a large clinical trial of β-lactam antibiotics in severe sepsis, ARC was not associated with any differences in outcomes, regardless of dosing strategy.

X Demographics

X Demographics

The data shown below were collected from the profiles of 4 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 101 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 101 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 15 15%
Student > Ph. D. Student 11 11%
Student > Master 10 10%
Student > Bachelor 8 8%
Student > Postgraduate 7 7%
Other 19 19%
Unknown 31 31%
Readers by discipline Count As %
Medicine and Dentistry 34 34%
Pharmacology, Toxicology and Pharmaceutical Science 15 15%
Biochemistry, Genetics and Molecular Biology 3 3%
Nursing and Health Professions 3 3%
Agricultural and Biological Sciences 2 2%
Other 7 7%
Unknown 37 37%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. 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 16 October 2022.
All research outputs
#15,173,117
of 25,382,440 outputs
Outputs from International Journal of Antimicrobial Agents
#1,811
of 3,030 outputs
Outputs of similar age
#171,055
of 321,120 outputs
Outputs of similar age from International Journal of Antimicrobial Agents
#22
of 55 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,030 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.3. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
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 321,120 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 55 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 56% of its contemporaries.