Evidence map›Paper›PMID 24356862›Full record

Trial reportIntensive care medicine2014

Therapeutic drug monitoring-based dose optimisation of piperacillin and meropenem: a randomised controlled trial.

Jan J De Waele, S Carrette, M Carlier, V Stove, J Boelens, G Claeys, I Leroux-Roels, E Hoste, P Depuydt, J Decruyenaere and 1 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03634904 (Prospective Observational Study of Serum Ceftazidime Concentrations in Hemodialysis Patients at the University Hospital of Charleroi, Belgium), which is not on this map. Cited by 92 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03634904 naunknown statusnot on this mapstarted 2018, after this paper: background citation

Prospective Observational Study of Serum Ceftazidime Concentrations in Hemodialysis Patients at the University Hospital of Charleroi, Belgium

TypeinterventionalSponsorCentre Hospitalier Universitaire de CharleroiRan2018 to 2021Enrolled20ConditionsBacterial Infections, Ceftazidime, Renal Failure Chronic Requiring HemodialysisArmsDrug bood sampling
3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  3. Beta-Lactam Antibiotic Therapeutic Drug Monitoring in Critically Ill Patients: A Systematic Review and Meta-Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
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32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jan J De WaeleDepartment of Critical Care Medicine, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium, Jan.dewaele@ugent.be.
S Carrette
M Carlier
V Stove
J Boelens
G Claeys
I Leroux-Roels
E Hoste
P Depuydt
J Decruyenaere
A G Verstraete

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere is variability in the pharmacokinetics (PK) of antibiotics (AB) in critically ill patients. Therapeutic drug monitoring (TDM) could overcome this variability and increase PK target attainment. The objective of this study was to analyse the effect of a dose-adaption strategy based on daily TDM on target attainment.

methodsThis was a prospective, partially blinded, and randomised controlled trial in patients with normal kidney function treated with meropenem (MEM) or piperacillin/tazobactam (PTZ). The intervention group underwent daily TDM, with dose adjustment when necessary. The predefined PK/pharmacodynamic (PK/PD) target was 100% fT>4MIC [percentage of time during a dosing interval that the free (f) drug concentration exceeded 4 times the MIC]. The control group received conventional treatment. The primary endpoint was the proportion of patients that reached 100% fT>4MIC and 100 % fT>MIC at 72 h.

resultsForty-one patients (median age 56 years) were included in the study. Pneumonia was the primary infectious diagnosis. At baseline, 100% fT>4MIC was achieved in 21% of the PTZ patients and in none of the MEM patients; 100% fT>MIC was achieved in 71% of the PTZ patients and 46 % of the MEM patients. Of the patients in the intervention group, 76 % needed dose adaptation, and five required an additional increase. At 72 h, target attainment rates for 100% fT>4MIC and 100% fT>MIC were higher in the intervention group: 58 vs. 16%, p = 0.007 and 95 vs. 68%, p = 0.045, respectively.

conclusionsAmong critically ill patients with normal kidney function, a strategy of dose adaptation based on daily TDM led to an increase in PK/PD target attainment compared to conventional dosing.

Indexed as

beta-Lactamase InhibitorsCreatineCritical IllnessDose-Response Relationship, DrugDrug MonitoringFemaleHumansMaleMeropenemPenicillanic AcidPiperacillinPiperacillin, Tazobactam Drug CombinationProspective StudiesThienamycinsbeta-Lactamase InhibitorsCreatineMeropenemPenicillanic AcidPiperacillinPiperacillin, Tazobactam Drug CombinationThienamycins

Identifiers

PMID24356862

What OpenQuestion holds

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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.