ArticleClinical pharmacokinetics2007
Clinical scoring system for the prediction of target site penetration of antimicrobials in patients with sepsis.
Article in Clinical pharmacokinetics, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Risk Factors Associated with Antibiotic Exposure Variability in Critically Ill Patients: A Systematic Review.Antibiotics (Basel, Switzerland) · 2024Review
- Understanding antimicrobial pharmacokinetics in critically ill patients to optimize antimicrobial therapy: A narrative review.Journal of intensive medicine · 2024Review
- Biomarkers Predicting Tissue Pharmacokinetics of Antimicrobials in Sepsis: A Review.Clinical pharmacokinetics · 2022Review
- Clinical Pharmacokinetics and Pharmacodynamics of Oxazolidinones.Clinical pharmacokinetics · 2018Review
- [Tissue penetration of antibiotics. Does the treatment reach the target site?].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Review
- Effect of cardiopulmonary bypass on regional antibiotic penetration into lung tissue.Antimicrobial agents and chemotherapy · 2013Article
- Antibiotic dosing in the 'at risk' critically ill patient: Linking pathophysiology with pharmacokinetics/pharmacodynamics in sepsis and trauma patients.BMC anesthesiology · 2011Article
- Microdialysis for assessing intratumoral drug disposition in brain cancers: a tool for rational drug development.Expert opinion on drug metabolism & toxicology · 2010Review
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThe present study investigated the usefulness of routinely employed scoring systems in predicting tissue penetration of antimicrobials. In addition, a novel, easy to use scoring system was designed for the estimation of tissue penetration of antimicrobials in patients with sepsis.
methodsTissue pharmacokinetics were assessed in skeletal muscle and subcutaneous adipose tissue by use of the microdialysis technique in 34 patients with sepsis. Tissue penetration of antimicrobials was retrospectively determined by the ratios of the area under the concentration-time curves (AUC) in soft tissues (AUCtissue) to the AUC in plasma (AUCplasma). Mortality and sepsis scores currently used in intensive care were consecutively calculated and correlated with the AUCtissue:AUCplasma ratio. Single laboratory and clinical parameters showing the highest correlation with tissue penetration were identified and used in the novel Tissue Penetration Prediction Score (TPPS).
resultsThe currently used scoring systems Simplified Acute Physiology Scores 3 (r=-0.33, p=0.006), Acute Physiology and Chronic Health Evaluation III (r=-0.27, p=0.03) and Sepsis-Related (or Sequential) Organ Failure Assessment (r=-0.32, p=0.01) showed significant overall correlations with tissue penetration. However, their predictive power for the concentrations of antimicrobials in muscle tissue was not satisfying. The parameters oxygen saturation, serum lactate concentration and the dose per time unit of norepinephrine (noradrenaline) administered showed the best correlation with tissue penetration and were used in the TPPS. Its overall correlation (r=-0.52, p=0.000007) as well as correlations for the concentrations of antimicrobials in muscle (r=-0.46, p=0.006) and adipose tissue (r=-0.59, p=0.0003) were better than the currently used scoring systems.
conclusionThe TPPS may prove to be a powerful tool for the estimation of antimicrobial tissue penetration at the bedside in septic patients. This score may allow for adequate individual dose adjustment in septic patients. However, this needs to be verified in subsequent prospective clinical trials.
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