SynthesisCritical care (London, England)2011
Antibiotics in critically ill patients: a systematic review of the pharmacokinetics of β-lactams.
Synthesis in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 187 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pharmacokinetic Evaluation of Cefepime Administrered Intravenously in Intensive Care Patients
Plasma Protein Binding and Population Pharmacokinetics and Pharmacodynamics of Total and Unbound Temocillin in Patients With Complicated Urinary Tract Infection or Pyelonephritis, Lower Respiratory Tract Infection, or Abdominal Infection.
Who cites it
187 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Systematic review and meta-analysis to identify meropenem exposures and pharmacological targets predictive of clinical outcomes.The Journal of antimicrobial chemotherapy · 2026Pooled it
- [S3 guideline on renal replacement therapy in intensive care medicine : Evidence-based implementation of renal replacement therapy in critically ill patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Dynamic distribution of systemically administered antibiotics in orthopeadically relevant target tissues and settings.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2024Pooled it
- Population Pharmacokinetic Meta-Analysis and Dosing Recommendation for Meropenem in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.Antimicrobial agents and chemotherapy · 2022Pooled it
- A systematic review of the effect of therapeutic drug monitoring on patient health outcomes during treatment with penicillins.The Journal of antimicrobial chemotherapy · 2022Pooled it
- Comparing clinical outcomes of piperacillin-tazobactam administration and dosage strategies in critically ill adult patients: a systematic review and meta-analysis.BMC infectious diseases · 2020Pooled it
- Optimization of the treatment with beta-lactam antibiotics in critically ill patients-guidelines from the French Society of Pharmacology and Therapeutics (Société Française de Pharmacologie et Thérapeutique-SFPT) and the French Society of Anaesthesia and Intensive Care Medicine (Société Française d'Anesthésie et Réanimation-SFAR).Critical care (London, England) · 2019Guideline
- Population Pharmacokinetic Modeling and Target Attainment of Cefepime in Critically Ill Pediatric Patients.Open forum infectious diseases · 2026Trial
- Unraveling the impact of therapeutic drug monitoring via machine learning for patients with sepsis.Cell reports. Medicine · 2024Trial
- Comparative Plasma and Interstitial Tissue Fluid Pharmacokinetics of Meropenem Demonstrate the Need for Increasing Dose and Infusion Duration in Obese and Non-obese Patients.Clinical pharmacokinetics · 2022Trial
- Evaluation of pharmacokinetic and pharmacodynamic parameters of meropenem in critically ill patients with acute kidney disease.European journal of clinical pharmacology · 2021Trial
- Population Pharmacokinetic Analysis for Plasma and Epithelial Lining Fluid Ceftolozane/Tazobactam Concentrations in Patients With Ventilated Nosocomial Pneumonia.Journal of clinical pharmacology · 2021Trial
- Population Pharmacokinetic Model to Optimize Cefotaxime Dosing Regimen in Critically Ill Children.Clinical pharmacokinetics · 2018Trial
- Pharmacokinetic and Pharmacodynamic Efficacies of Continuous versus Intermittent Administration of Meropenem in Patients with Severe Sepsis and Septic Shock: A Prospective Randomized Pilot Study.Chinese medical journal · 2017Trial
- Population pharmacokinetics of ceftolozane/tazobactam in healthy volunteers, subjects with varying degrees of renal function and patients with bacterial infections.Journal of clinical pharmacology · 2015Trial
- Assessment of pharmacokinetic changes of meropenem during therapy in septic critically ill patients.BMC pharmacology & toxicology · 2014Trial
- Therapeutic drug monitoring-based dose optimisation of piperacillin and meropenem: a randomised controlled trial.Intensive care medicine · 2014Trial
- A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia.Critical care (London, England) · 2012Trial
- Clinical and microbiological efficacy of continuous versus intermittent application of meropenem in critically ill patients: a randomized open-label controlled trial.Critical care (London, England) · 2012Trial
- Pyridoxic Acid as a Novel Endogenous Biomarker for OAT-Mediated Clearance of Meropenem: A Population Pharmacokinetic Modeling and PK/PD-Response Analysis in Patients with Sepsis.Pharmaceutics · 2026Article
127 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSeveral reports have shown marked heterogeneity of antibiotic pharmacokinetics (PK) in patients admitted to ICUs, which might potentially affect outcomes. Therefore, the pharmacodynamic (PD) parameter of the efficacy of β-lactam antibiotics, that is, the time that its concentration is above the bacteria minimal inhibitory concentration (T > MIC), cannot be safely extrapolated from data derived from the PK of healthy volunteers.
methodsWe performed a full review of published studies addressing the PK of intravenous β-lactam antibiotics given to infected ICU patients. Study selection comprised a comprehensive bibliographic search of the PubMed database and bibliographic references in relevant reviews from January 1966 to December 2010. We selected only English-language articles reporting studies addressing β-lactam antibiotics that had been described in at least five previously published studies. Studies of the PK of patients undergoing renal replacement therapy were excluded.
resultsA total of 57 studies addressing six different β-lactam antibiotics (meropenem, imipenem, piperacillin, cefpirome, cefepime and ceftazidime) were selected. Significant PK heterogeneity was noted, with a broad, more than twofold variation both of volume of distribution and of drug clearance (Cl). The correlation of antibiotic Cl with creatinine clearance was usually reported. Consequently, in ICU patients, β-lactam antibiotic half-life and T > MIC were virtually unpredictable, especially in those patients with normal renal function. A better PD profile was usually obtained by prolonged or even continuous infusion. Tissue penetration was also found to be compromised in critically ill patients with septic shock.
conclusionsThe PK of β-lactam antibiotics are heterogeneous and largely unpredictable in ICU patients. Consequently, the dosing of antibiotics should be supported by PK concepts, including data derived from studies of the PK of ICU patients and therapeutic drug monitoring.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.