Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Abdul-Aziz, Mohd H., Lipman, Jeffrey, Akova, Murat, Bassetti, Matteo, De Waele, Jan J., Dimopoulos, George, Dulhunty, Joel, Kaukonen, Kirsi-Maija, Koulenti, Despoina, Martin, Claude, Montravers, Philippe, Rello, Jordi, Rhodes, Andrew, Starr, Therese, Wallis, Steven C., Roberts, Jason A., Paul, Sanjoy, Ribas, Antonio Margarit, De Crop, Luc, Spapen, Herbert, Wauters, Joost, Dugernier, Thierry, Jorens, Philippe, Dapper, Ilse, De Backer, Daniel, Taccone, Fabio S., Ruano, Laura, Afonso, Elsa, Alvarez-Lerma, Francisco, Gracia-Arnillas, Maria Pilar, Fernandez, Francisco, Feijoo, Neus, Bardolet, Neus, Rovira, Assumpta, Garro, Pau, Colon, Diana, Castillo, Carlos, Fernado, Juan, Lopez, Maria Jesus, Fernandez, Jose Luis, Arribas, Ana Maria, Teja, Jose Luis, Ots, Elsa, Montejo, Juan Carlos, Catalan, Marcedes, Prieto, Isidro, Gonzalo, Gloria, Galvan, Beatriz, Blasco, Miguel Ange, Meyer, Estibaliz, Nogal, Frutos Del, Vidaur, Loreto, Sebastian, Rosa, Garde, Pila Marco, Velasco, Maria del Mar Martin, Crespo, Rafael Zaragoza, Esperatti, Mariano, Torres, Antoni, Baldesi, Olivier, Dupont, Herve, Mahjoub, Yazine, Lasocki, Sigismond, Constantin, Jean Michel, Payen, Jean Francois, Albanese, Jacques, Malledant, Yannick, Pottecher, Julien, Lefrant, Jean-Yves, Jaber,Samir, Joannes-Boyau, Olivier, Orban,Christophe, Ostermann, Marlies, McKenzie, Catherine, Berry, Willaim, Smith, John, Lei, Katie, Rubulotta, Francesca, Gordon, Anthony, Brett, Stephen, Stotz, Martin, Templeton, Maie, Ebm, Claudia, Moran, Carl, Pettila, Ville, Xristodoulou, Aglaia, Theodorou, Vassiliki, Kouliatsis, Georgios, Sertaridou, Eleni, Anthopoulos, Georgios, Choutas, George, Rantis, Thanos, Karatzas, Stylianos, Balla, Margarita, Papanikolaou, Metaxia, Myrianthefs, Pavlos, Gavala, Alexandra, Fildisis, Georgios, Koutsoukou, Antonia, Kyriakopoulou, Magdalini, Petrochilou, Kalomoira, Kompoti, Maria, Michalia, Martha, Clouva-Molyvdas, Fillis-Maria, Gkiokas, Georgios, Nikolakopoulos, Fotios, Psychogiou, Vasiliki, Malliotakis, Polychronis, Akoumianaki, Evangelia, Lilitsis, Emmanouil, Koulouras, Vassilios, Nakos, George, Kalogirou, Mihalis, Komnos, Apostolos, Zafeiridis, Tilemachos, Chaintoutis, Christos, Arvaniti, Kostoula, Matamis, Dimitrios, Kydona, Christina, Gritsi-Gerogianni, Nikoleta, Giasnetsova, Tatiana, Giannakou, Maria, Soultati, Ioanna, Chytas, Ilias, Antoniadou, Eleni, Antipa, Elli, Lathyris, Dimitrios, Koukoubani,Triantafyllia, Paraforou, Theoniki, Spiropoulou, Kyriaki, Bekos, Vasileios, Spring, Anna, Kalatzi, Theodora, Nikolaou, Hara, Laskou, Maria, Strouvalis, Ioannis, Aloizos, Stavros, Kapogiannis, Spyridon, Soldatou, Ourania, Adembri, Chiara, Villa, Gianluca, Giarratano, Antonio, Raineri, Santi Maurizio, Cortegiani, Andrea, Montalto, Francesca, Strano, Maria Teresa, Ranieri, V. Marco, Sandroni, Claudio, De Pascale, Gennaro, Molin, Alexandre, Pelosi, Paolo, Montagnani, Luca, Urbino, Rosario, Mastromauro, Ilaria, De Rosa, Francesco G., Cardoso, Teresa, Afonso, Susana, Goncalves-Pereira, Joao, Baptista, Joao Pedro and Ozveren, Arife (2016) Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort. Journal of Antimicrobial Chemotherapy, 71 1: 196-207. doi:10.1093/jac/dkv288


Author Abdul-Aziz, Mohd H.
Lipman, Jeffrey
Akova, Murat
Bassetti, Matteo
De Waele, Jan J.
Dimopoulos, George
Dulhunty, Joel
Kaukonen, Kirsi-Maija
Koulenti, Despoina
Martin, Claude
Montravers, Philippe
Rello, Jordi
Rhodes, Andrew
Starr, Therese
Wallis, Steven C.
Roberts, Jason A.
Paul, Sanjoy
Ribas, Antonio Margarit
De Crop, Luc
Spapen, Herbert
Wauters, Joost
Dugernier, Thierry
Jorens, Philippe
Dapper, Ilse
De Backer, Daniel
Taccone, Fabio S.
Ruano, Laura
Afonso, Elsa
Alvarez-Lerma, Francisco
Gracia-Arnillas, Maria Pilar
Fernandez, Francisco
Feijoo, Neus
Bardolet, Neus
Rovira, Assumpta
Garro, Pau
Colon, Diana
Castillo, Carlos
Fernado, Juan
Lopez, Maria Jesus
Fernandez, Jose Luis
Arribas, Ana Maria
Teja, Jose Luis
Ots, Elsa
Montejo, Juan Carlos
Catalan, Marcedes
Prieto, Isidro
Gonzalo, Gloria
Galvan, Beatriz
Blasco, Miguel Ange
Meyer, Estibaliz
Nogal, Frutos Del
Vidaur, Loreto
Sebastian, Rosa
Garde, Pila Marco
Velasco, Maria del Mar Martin
Crespo, Rafael Zaragoza
Esperatti, Mariano
Torres, Antoni
Baldesi, Olivier
Dupont, Herve
Mahjoub, Yazine
Lasocki, Sigismond
Constantin, Jean Michel
Payen, Jean Francois
Albanese, Jacques
Malledant, Yannick
Pottecher, Julien
Lefrant, Jean-Yves
Jaber,Samir
Joannes-Boyau, Olivier
Orban,Christophe
Ostermann, Marlies
McKenzie, Catherine
Berry, Willaim
Smith, John
Lei, Katie
Rubulotta, Francesca
Gordon, Anthony
Brett, Stephen
Stotz, Martin
Templeton, Maie
Ebm, Claudia
Moran, Carl
Pettila, Ville
Xristodoulou, Aglaia
Theodorou, Vassiliki
Kouliatsis, Georgios
Sertaridou, Eleni
Anthopoulos, Georgios
Choutas, George
Rantis, Thanos
Karatzas, Stylianos
Balla, Margarita
Papanikolaou, Metaxia
Myrianthefs, Pavlos
Gavala, Alexandra
Fildisis, Georgios
Koutsoukou, Antonia
Kyriakopoulou, Magdalini
Petrochilou, Kalomoira
Kompoti, Maria
Michalia, Martha
Clouva-Molyvdas, Fillis-Maria
Gkiokas, Georgios
Nikolakopoulos, Fotios
Psychogiou, Vasiliki
Malliotakis, Polychronis
Akoumianaki, Evangelia
Lilitsis, Emmanouil
Koulouras, Vassilios
Nakos, George
Kalogirou, Mihalis
Komnos, Apostolos
Zafeiridis, Tilemachos
Chaintoutis, Christos
Arvaniti, Kostoula
Matamis, Dimitrios
Kydona, Christina
Gritsi-Gerogianni, Nikoleta
Giasnetsova, Tatiana
Giannakou, Maria
Soultati, Ioanna
Chytas, Ilias
Antoniadou, Eleni
Antipa, Elli
Lathyris, Dimitrios
Koukoubani,Triantafyllia
Paraforou, Theoniki
Spiropoulou, Kyriaki
Bekos, Vasileios
Spring, Anna
Kalatzi, Theodora
Nikolaou, Hara
Laskou, Maria
Strouvalis, Ioannis
Aloizos, Stavros
Kapogiannis, Spyridon
Soldatou, Ourania
Adembri, Chiara
Villa, Gianluca
Giarratano, Antonio
Raineri, Santi Maurizio
Cortegiani, Andrea
Montalto, Francesca
Strano, Maria Teresa
Ranieri, V. Marco
Sandroni, Claudio
De Pascale, Gennaro
Molin, Alexandre
Pelosi, Paolo
Montagnani, Luca
Urbino, Rosario
Mastromauro, Ilaria
De Rosa, Francesco G.
Cardoso, Teresa
Afonso, Susana
Goncalves-Pereira, Joao
Baptista, Joao Pedro
Ozveren, Arife
Title Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort
Journal name Journal of Antimicrobial Chemotherapy   Check publisher's open access policy
ISSN 1460-2091
0305-7453
Publication date 2016-01
Year available 2015
Sub-type Article (original research)
DOI 10.1093/jac/dkv288
Open Access Status Not Open Access
Volume 71
Issue 1
Start page 196
End page 207
Total pages 12
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2017
Language eng
Formatted abstract
Objectives: We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged- infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.

Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.

Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fTMIC (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving β-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of ≥ 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].

Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections.
Keyword Defining Antibiotic Levels in Intensive care unit patients (DALI) study
Pharmacokinetic/pharmacodynamic
Critically ill patients
Piperacillin/tazobactam
Respiratory infections
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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