Therapeutic Drug Monitoring of Beta-Lactam Antibiotics in Burns Patients—A One-Year Prospective Study

2012 ◽  
Vol 34 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Bhavik M. Patel ◽  
Jennifer Paratz ◽  
Natalie C. See ◽  
Michael J. Muller ◽  
Michael Rudd ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Prospective Study ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
One Year

Therapeutic drug monitoring of beta-lactam antibiotics – Influence of sample stability on the analysis of piperacillin, meropenem, ceftazidime and flucloxacillin by HPLC-UV

2017 ◽  
Vol 143 ◽  
pp. 86-93 ◽  
Author(s):  
Nadine Pinder ◽  
Thorsten Brenner ◽  
Stefanie Swoboda ◽  
Markus A. Weigand ◽  
Torsten Hoppe-Tichy
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Sample Stability

scholarly journals Simultaneous Determination of 12 β-Lactam Antibiotics in Human Plasma by High-Performance Liquid Chromatography with UV Detection: Application to Therapeutic Drug Monitoring

2011 ◽  
Vol 55 (10) ◽  
pp. 4873-4879 ◽  
Author(s):  
Marie-Clémence Verdier ◽  
Olivier Tribut ◽  
Pierre Tattevin ◽  
Yves Le Tulzo ◽  
Christian Michelet ◽  
...  
Keyword(s):  
High Performance Liquid Chromatography ◽  
Liquid Chromatography ◽  
Therapeutic Drug Monitoring ◽  
Simultaneous Determination ◽  
Drug Monitoring ◽  
High Performance ◽  
Therapeutic Drug ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics

ABSTRACTA rapid and specific high-performance liquid chromatography method with UV detection (HPLC-UV) for the simultaneous determination of 12 beta-lactam antibiotics (amoxicillin, cefepime, cefotaxime, ceftazidime, ceftriaxone, cloxacillin, imipenem, meropenem, oxacillin, penicillin G, piperacillin, and ticarcillin) in small samples of human plasma is described. Extraction consisted of protein precipitation by acetonitrile. An Atlantis T3 analytical column with a linear gradient of acetonitrile and a pH 2 phosphoric acid solution was used for separation. Wavelength photodiode array detection was set either at 210 nm, 230 nm, or 298 nm according to the compound. This method is accurate and reproducible (coefficient of variation [CV] < 8%), allowing quantification of beta-lactam plasma levels from 5 to 250 μg/ml without interference with other common drugs. This technique is easy to use in routine therapeutic drug monitoring of beta-lactam antibiotics.

scholarly journals 1114. Effectiveness and Safety of Beta-lactam Antibiotics with and without Therapeutic Drug Monitoring in Patients with Pseudomonas aeruginosa Pneumonia or Bloodstream Infection

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S650-S650
Author(s):  
Ashlan J Kunz Coyne ◽  
Mohammad H Al-Shaer ◽  
Anthony M Casapao ◽  
Jason Ferreira ◽  
Carmen Isache ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Therapeutic Drug Monitoring ◽  
Bloodstream Infection ◽  
Drug Monitoring ◽  
Clinical Cure ◽  
Therapeutic Drug ◽  
Composite Outcome ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Primary Composite Outcome

Abstract Background Pseudomonas aeruginosa (PSAR) is challenging to treat due to its multiple resistance mechanisms, limited anti-PSAR agents, and population pharmacokinetic (PK) variances. Beta-lactam antibiotics (BLA) are commonly used to treat PSAR infections and although they have a wide therapeutic index, suboptimal exposures may lead to treatment failure and antimicrobial resistance while high exposure may result in adverse effects. Certain patient populations may benefit from BLA therapeutic drug monitoring (TDM) due to their significant PK variability. The purpose of this study was to compare clinical outcomes in patients with PSAR pneumonia (PNA) or bloodstream infection (BSI) receiving BLA with and without the guidance of TDM. Methods Retrospective, parallel cohort study conducted at UF Shands Gainesville and UF Health Jacksonville evaluating five years of patients with PSAR PNA or BSI. TDM group was defined for routine BLA TDM compared to nonroutine BLA TDM service (non-TDM). Patients were excluded if they died before a culture result, transferred in with a positive PSAR culture, were transplant recipients, cystic fibrosis or burn injury patients. The primary outcome was a composite of presumed clinical cure defined as the absence of the following: all-cause in-hospital mortality, escalation, and/or additional antimicrobial therapy for PSAR infection after 48 hours of treatment with primary susceptible regimen due to worsening clinical status or transfer to a higher level of care. Results Two-hundred patients were included (TDM n=95; non-TDM n=105). The overall primary composite outcome of presumed clinical cure occurred in 73% of patients (82% and 75% of the TDM and non-TDM cohorts, respectively; p=0.301). A post-hoc multivariate analysis was conducted to assess predictors of not attaining clinical cure. Conclusion While there was no difference in the primary composite outcome of presumed clinical cure, future studies can use these data to assess TDM patient selection and whether a bundled care approach of BLA regimens with known clinical benefit, early TDM-guided dose optimization, and continued clinical assessment improves outcomes in patients with PSAR PNA or BSI compared to use of each modality individually. Disclosures All Authors: No reported disclosures

Barriers and facilitators in the clinical implementation of beta-lactam therapeutic drug monitoring in critically ill patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alan Abdulla ◽  
Puck van den Broek ◽  
Tim M.J. Ewoldt ◽  
Anouk E. Muller ◽  
Henrik Endeman ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Critically Ill ◽  
Drug Monitoring ◽  
Critically Ill Patients ◽  
Barriers And Facilitators ◽  
Therapeutic Drug ◽  
Clinical Implementation ◽  
Beta Lactam

903: MICROBIOLOGICAL AND CLINICAL OUTCOMES OF BETA-LACTAM THERAPEUTIC DRUG MONITORING IN THE PICU

2016 ◽  
Vol 44 (12) ◽  
pp. 302-302
Author(s):  
Jeffrey Cies ◽  
Wayne Moore ◽  
Adela Enache ◽  
Arun Chopra
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Clinical Outcomes ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Beta Lactam

Therapeutic Drug Monitoring of Clozapine in Relapse Prevention: A Five-Year Prospective Study

2001 ◽  
Vol 21 (3) ◽  
pp. 305-310 ◽  
Author(s):  
Ines Gaertner ◽  
Hans Jörg Gaertner ◽  
Reinhard Vonthein ◽  
Klaus Dietz
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Prospective Study ◽  
Drug Monitoring ◽  
Relapse Prevention ◽  
Therapeutic Drug

scholarly journals 1101. Implementing a Beta-Lactam Therapeutic Drug Monitoring Program: Experience from a Large Academic Medical Center

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S642-S642
Author(s):  
Venugopalan Veena ◽  
Malva Hamza ◽  
Barbara A Santevecchi ◽  
Kathryn DeSear ◽  
Kartikeya Cherabuddi ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Dosage Adjustment ◽  
Total Serum ◽  
Therapeutic Drug ◽  
Beta Lactam ◽  
Dose Individualization ◽  
Material Support ◽  
Drug Concentrations ◽  
Drug Registry

Abstract Background Beta-lactams (BL) are the cornerstone of antimicrobial treatment for infections. Beta-lactam therapeutic drug monitoring (BL-TDM) optimizes drug concentrations to ensure maximal efficacy and minimal toxicity. The goals of this study were to describe the implementation process of a BL-TDM program and to further describe our experience using BL-TDM in clinical practice. Methods This was a retrospective review of adult patients with available BL-TDM between January 2016 and November 2019 at the University of Florida (UF) Health Shands Hospital. Total serum concentrations of BL were measured in the Infectious Diseases Pharmacokinetics Lab (IDPL) at UF, using a validated ultrahigh pressure liquid chromatography assay with triple quadrupole mass spectroscopy (LC-MS-MS). At our institution, TDM is available for 11 BLs and in-house assays are performed from Mon-Fri for most BLs. Results A total of 3,030 BL concentrations were obtained. An analysis was performed on the first BL-TDM encounter in 1,438 patients. The median age was 57 years (IQR, 41-69) and the median BMI was 27.5 kg/m2 (IQR, 22.5-34.5). On the day of BL-TDM, the median serum creatinine was 0.83 (IQR, 0.59-1.30). Fifty-one percent of patients (n=735) were in an ICU at the time of BL-TDM with a median SOFA score of 6 (IQR, 3-9). BL-TDM was most frequently performed on cefepime (61%, n=882), piperacillin (15%, n=218), and meropenem (11%, n=151). The BL was administered as a continuous infusion in 211 (15%) patients. An interim analysis of 548 patients showed that BL-TDM was performed a median of 2 days (IQR, 1-4) from the start of BL therapy and resulted in a dosage adjustment in 26% (n=145). Conclusion BL-TDM was performed in older, non-obese patients with normal renal function. Over half of the evaluated patients were in an ICU at the time of TDM. This finding emphasizes the value of BL-TDM in the ICU setting because altered pharmacokinetics during critical illness has been linked to enhanced BL clearance. Interestingly, BL-TDM resulted in dosage adjustment in 1 in 4 patients who were receiving licensed BL dosing regimens, thus highlighting the role of TDM in dose individualization. BL-TDM was performed most commonly within the 72-hours of therapy initiation. Early BL-TDM has been shown to improve patient outcomes and should be promoted. Disclosures Venugopalan Veena, PharmD, Melinta (Other Financial or Material Support, Received a stipend for participation in a drug registry)Merck (Other Financial or Material Support, Received a stipend for participation in a drug registry) Charles A. Peloquin, Pharm.D., Nothing to disclose

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