Title |
Even high-dose extended infusions may not yield desired concentrations of β-lactams: the value of therapeutic drug monitoring
|
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Published in |
Infectious Diseases, March 2015
|
DOI | 10.3109/23744235.2015.1021831 |
Pubmed ID | |
Authors |
Menino Osbert Cotta, Belinda Gowen, Natasha Truloff, Evan Bursle, Brett McWhinney, Jacobus P.J. Ungerer, Jason A. Roberts, Jeffrey Lipman |
Abstract |
A 35-year-old patient in intensive care with severe burn injury developed episodes of sepsis. Blood culture yielded a multidrug-resistant Pseudomonas aeruginosa and treatment was commenced with amikacin (minimum inhibitory concentration (MIC) 2-4 mg/L, dose 20 mg/kg adjusted body weight 24-hourly) and meropenem (MIC 8 mg/L, dose 2 g IV 8-hourly and later 6-hourly). Despite the use of extended infusions with β-lactam therapeutic drug monitoring and doses that were more than 2.5 times higher than standard meropenem doses, resistance emerged. This case report describes the application of therapeutic drug monitoring to optimize β-lactam therapy in a difficult-to-treat critically ill patient. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 25% |
Canada | 1 | 25% |
Unknown | 2 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 4 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 37 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 6 | 16% |
Researcher | 6 | 16% |
Student > Master | 6 | 16% |
Professor > Associate Professor | 4 | 11% |
Lecturer | 3 | 8% |
Other | 4 | 11% |
Unknown | 8 | 22% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 15 | 41% |
Pharmacology, Toxicology and Pharmaceutical Science | 5 | 14% |
Immunology and Microbiology | 3 | 8% |
Biochemistry, Genetics and Molecular Biology | 2 | 5% |
Agricultural and Biological Sciences | 1 | 3% |
Other | 3 | 8% |
Unknown | 8 | 22% |