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Pharmacokinetic/pharmacodynamic target attainment of intravenous β-lactam regimens against Gram-negative bacteria isolated in a Brazilian teaching hospital

Overview of attention for article published in Revista da Sociedade Brasileira de Medicina Tropical, October 2015
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Title
Pharmacokinetic/pharmacodynamic target attainment of intravenous β-lactam regimens against Gram-negative bacteria isolated in a Brazilian teaching hospital
Published in
Revista da Sociedade Brasileira de Medicina Tropical, October 2015
DOI 10.1590/0037-8682-0122-2015
Pubmed ID
Authors

Guilherme Henrique Furtado, Leandro Cardinal, Rodrigo Spineli Macedo, Juliana Oliveira Silva, Eduardo Alexandrino Medeiros, Joseph Levente Kuti, David Paul Nicolau

Abstract

Monte Carlo simulations have been used for selecting optimal antibiotic regimens for treatment of bacterial infections. The aim of this study was to assess the pharmacokinetic and pharmacodynamic target attainment of intravenous β-lactam regimens commonly used to treat bloodstream infections (BSIs) caused by Gram-negative rod-shaped organisms in a Brazilian teaching hospital. In total, 5,000 patients were included in the Monte Carlo simulations of distinct antimicrobial regimens to estimate the likelihood of achieving free drug concentrations above the minimum inhibitory concentration (MIC; fT > MIC) for the requisite periods to clear distinct target organisms. Microbiological data were obtained from blood culture isolates harvested in our hospital from 2008 to 2010. In total, 614 bacterial isolates, including Escherichia coli, Enterobacterspp., Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, were analyzed Piperacillin/tazobactam failed to achieve a cumulative fraction of response (CFR) > 90% for any of the isolates. While standard dosing (short infusion) of β-lactams achieved target attainment for BSIs caused by E. coliand Enterobacterspp., pharmacodynamic target attainment against K. pneumoniaeisolates was only achieved with ceftazidime and meropenem (prolonged infusion). Lastly, only prolonged infusion of high-dose meropenem approached an ideal CFR against P. aeruginosa; however, no antimicrobial regimen achieved an ideal CFR against A. baumannii. These data reinforce the use of prolonged infusions of high-dose β-lactam antimicrobials as a reasonable strategy for the treatment of BSIs caused by multidrug resistant Gram-negative bacteria in Brazil.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 46 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 8 17%
Student > Bachelor 7 15%
Student > Ph. D. Student 6 13%
Student > Master 4 9%
Other 3 7%
Other 3 7%
Unknown 15 33%
Readers by discipline Count As %
Medicine and Dentistry 12 26%
Pharmacology, Toxicology and Pharmaceutical Science 7 15%
Nursing and Health Professions 3 7%
Biochemistry, Genetics and Molecular Biology 2 4%
Agricultural and Biological Sciences 2 4%
Other 4 9%
Unknown 16 35%
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 12 April 2016.
All research outputs
#15,739,010
of 25,373,627 outputs
Outputs from Revista da Sociedade Brasileira de Medicina Tropical
#427
of 1,193 outputs
Outputs of similar age
#147,345
of 286,873 outputs
Outputs of similar age from Revista da Sociedade Brasileira de Medicina Tropical
#2
of 15 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,193 research outputs from this source. They receive a mean Attention Score of 2.9. This one has gotten more attention than average, scoring higher than 63% 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 286,873 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.