Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16612
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dc.contributor.authorUdy, Andrew A-
dc.contributor.authorDulhunty, Joel M-
dc.contributor.authorRoberts, Jason A-
dc.contributor.authorDavis, Joshua S-
dc.contributor.authorWebb, Steven A-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorGomersall, Charles-
dc.contributor.authorShirwadkar, Charudatt-
dc.contributor.authorEastwood, Glenn M-
dc.contributor.authorMyburgh, John-
dc.contributor.authorPaterson, David L-
dc.contributor.authorStarr, Therese-
dc.contributor.authorPaul, Sanjoy K-
dc.contributor.authorLipman, Jeffrey-
dc.contributor.authorBLING-II Investigators-
dc.contributor.authorANZICS Clinical Trials Group-
dc.date2017-03-09-
dc.date.accessioned2017-03-19T23:14:31Z-
dc.date.available2017-03-19T23:14:31Z-
dc.date.issued2017-03-09-
dc.identifier.citationInternational Journal of Antimicrobial Agents 2017; online first: 9 Marchen_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/16612-
dc.description.abstractAugmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded. Primary outcome was alive ICU-free days at Day 28. Secondary outcomes included 90-day mortality and clinical cure at 14 days following antibiotic cessation. A total of 254 patients were included, among which 45 (17.7%) manifested ARC [median (IQR) CLCr 165 (144–198) mL/min]. ARC patients were younger (P < 0.001), more commonly male (P = 0.04) and had less organ dysfunction (P < 0.001). There was no difference in ICU-free days at Day 28 [ARC, 21 (12–24) days; no ARC, 21 (11–25) days; P = 0.89], although clinical cure was significantly greater in the unadjusted analysis in those manifesting ARC [33/45 (73.3%) vs. 115/209 (55.0%) P = 0.02]. This was attenuated in the multivariable analysis. No difference was noted in 90-day mortality. There were no statistically significant differences in clinical outcomes in ARC patients according to the dosing strategy employed. In this substudy of a large clinical trial of β-lactam antibiotics in severe sepsis, ARC was not associated with any differences in outcomes, regardless of dosing strategy.en_US
dc.subjectAugmented renal clearanceen_US
dc.subjectβ-Lactamsen_US
dc.subjectSepsisen_US
dc.subjectCritical illnessen_US
dc.titleAssociation between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trialen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleInternational Journal of Antimicrobial Agentsen_US
dc.identifier.affiliationDepartment of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationBurns, Trauma & Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationPharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationMenzies School of Health Research, Charles Darwin University, Darwin, NT, Australiaen_US
dc.identifier.affiliationDepartment of Infectious Diseases, John Hunter Hospital, Newcastle, NSW, Australiaen_US
dc.identifier.affiliationDepartment of Intensive Care, Royal Perth Hospital, Perth, WA, Australiaen_US
dc.identifier.affiliationSchool of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australiaen_US
dc.identifier.affiliationDepartment of Intensive Care, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationPrince of Wales Hospital, Hong Kong SARen_US
dc.identifier.affiliationChinese University of Hong Kong, Hong Kong SARen_US
dc.identifier.affiliationDepartment of Intensive Care, Blacktown Hospital, Blacktown, NSW, Australiaen_US
dc.identifier.affiliationCritical Care and Trauma Division, The George Institute for Global Health, Sydney, NSW, Australiaen_US
dc.identifier.affiliationSt George Clinical School, University of New South Wales, Sydney, NSW, Australiaen_US
dc.identifier.affiliationInfectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationThe University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationClinical Trials and Biostatistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australiaen_US
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/28286115en_US
dc.identifier.doi10.1016/j.ijantimicag.2016.12.022en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-1650-8939-
dc.type.austinJournal Articleen_US
local.name.researcherBellomo, Rinaldo
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeJournal Article-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
crisitem.author.deptIntensive Care-
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