SaMpling antibiotics in renal replacement therapy (SMARRT): an observational pharmacokinetic study in critically ill patients

Roberts, Jason A., Choi, Gordon Y. S., Joynt, Gavin M., Paul, Sanjoy K., Deans, Renae, Peake, Sandra, Cole, Louise, Stephens, Dianne, Bellomo, Rinaldo, Turnidge, John, Wallis, Steven C., Roberts, Michael S., Roberts, Darren M., Lassig-Smith, Melissa, Starr, Therese and Lipman, Jeffrey (2016) SaMpling antibiotics in renal replacement therapy (SMARRT): an observational pharmacokinetic study in critically ill patients. Bmc Infectious Diseases, 16 1: 103.1-103.8. doi:10.1186/s12879-016-1421-6


Author Roberts, Jason A.
Choi, Gordon Y. S.
Joynt, Gavin M.
Paul, Sanjoy K.
Deans, Renae
Peake, Sandra
Cole, Louise
Stephens, Dianne
Bellomo, Rinaldo
Turnidge, John
Wallis, Steven C.
Roberts, Michael S.
Roberts, Darren M.
Lassig-Smith, Melissa
Starr, Therese
Lipman, Jeffrey
Title SaMpling antibiotics in renal replacement therapy (SMARRT): an observational pharmacokinetic study in critically ill patients
Journal name Bmc Infectious Diseases   Check publisher's open access policy
ISSN 1471-2334
Publication date 2016-03-01
Year available 2016
Sub-type Article (original research)
DOI 10.1186/s12879-016-1421-6
Open Access Status DOI
Volume 16
Issue 1
Start page 103.1
End page 103.8
Total pages 8
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2017
Language eng
Formatted abstract
Background: Optimal antibiotic dosing is key to maximising patient survival, and minimising the emergence of bacterial resistance. Evidence-based antibiotic dosing guidelines for critically ill patients receiving RRT are currently not available, as RRT techniques and settings vary greatly between ICUs and even individual patients. We aim to develop a robust, evidence-based antibiotic dosing guideline for critically ill patients receiving various forms of RRT. We further aim to observe whether therapeutic antibiotic concentrations are associated with reduced 28-day mortality.

Methods/Design: We designed a multi-national, observational pharmacokinetic study in critically ill patients requiring RRT. The study antibiotics will be vancomycin, linezolid, piperacillin/tazobactam and meropenem. Pharmacokinetic sampling of each patient’s blood, RRT effluent and urine will take place during two separate dosing intervals. In addition, a comprehensive data set, which includes the patients’ demographic and clinical parameters, as well as modality, technique and settings of RRT, will be collected. Pharmacokinetic data will be analysed using a population pharmacokinetic approach to identify covariates associated with changes in pharmacokinetic parameters in critically ill patients with AKI who are undergoing RRT for the five commonly prescribed antibiotics.

Discussion: Using the comprehensive data set collected, the pharmacokinetic profile of the five antibiotics will be constructed, including identification of RRT and other factors indicative of the need for altered antibiotic dosing requirements. This will enable us to develop a dosing guideline for each individual antibiotic that is likely to be relevant to any critically ill patient with acute kidney injury receiving any of the included forms of RRT.

Trial registration: Australian New Zealand Clinical Trial Registry (ACTRN12613000241730) registered 28 February 2013
Keyword Sepsis
Antibiotic dosing
Dialysis
Pharmacokinetics
Pharmacodynamics
Vancomycin
Piperacillin
Tazobactam
Meropenem
Linezolid
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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