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Title: SaMpling Antibiotics in Renal Replacement Therapy (SMARRT): an observational pharmacokinetic study in critically ill patients
Austin Authors: Roberts, Jason A;Choi, Gordon YS;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
Affiliation: Burns Trauma and Critical Care Research Centre, The University of Queensland, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Royal Brisbane & Women’s Hospital, Herston, Queensland, Australia
Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
Clinical Trials & Biostatistics Unit, QIMR Berghofer, Herston, Queensland, Australia
Nepean Hospital, Kingswood, NSW, Australia
Royal Darwin Hospital, Darwin, Northern Territory, Australia
Austin Health, Heidelberg, Victoria, Australia
Royal Children’s Hospital, Herston, Queensland, Australia
Therapeutics Research Unit, The University of Queensland, Queensland, Australia
Issue Date: 1-Mar-2016
Publication information: BMC Infectious Diseases 2016; 16: 103
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.
DOI: 10.1186/s12879-016-1421-6
Journal: BMC Infectious Diseases
PubMed URL:
Type: Journal Article
Subjects: Acute Kidney Injury
Anti-Bacterial Agents
Renal Replacement Therapy
Type of Clinical Study or Trial: Clinical Trial
Appears in Collections:Journal articles

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