ArticleBMC infectious diseases2020
The effect of therapeutic drug monitoring of beta-lactam and fluoroquinolones on clinical outcome in critically ill patients: the DOLPHIN trial protocol of a multi-centre randomised controlled trial.
Article in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.
- 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
- Unraveling the impact of therapeutic drug monitoring via machine learning for patients with sepsis.Cell reports. Medicine · 2024Trial
- Model-informed precision dosing of beta-lactam antibiotics and ciprofloxacin in critically ill patients: a multicentre randomised clinical trial.Intensive care medicine · 2022Trial
- Population pharmacokinetics and target attainment of ciprofloxacin in critically ill patients.European journal of clinical pharmacology · 2020Trial
- Rising Carbapenem MICs and Clinical Dose Optimization: Bridging Resistance Surveillance and Pharmacokinetic/Pharmacodynamic Strategies.Antibiotics (Basel, Switzerland) · 2026Review
- Antimicrobial Pharmacokinetic and Pharmacodynamic Considerations in Special Populations: A Call to Action.Open forum infectious diseases · 2026Review
- Encephalopathy in mechanically ventilated adult patients in the intensive care unit: the role of β-Lactam overdosing.Scientific reports · 2026Article
- Model-Informed Precision Dosing: Conceptual Framework for Therapeutic Drug Monitoring Integrating Machine Learning and Artificial Intelligence Within Population Health Informatics.Journal of personalized medicine · 2026Review
- Next-generation hybrid bioanalytical platforms and clinical integration of TDM technologies for precision monitoring to optimize last-resort antibiotic therapy.Frontiers in pharmacology · 2026Review
- Clinical breakpoint meropenem concentration modulate outer membrane vesicle production in enterotoxigenic Bacteroides fragilis.Archives of microbiology · 2025Article
- Methods of Estimating Plasma Pharmacokinetics From Minimally Invasive, High Temporal Resolution Measurements of Interstitial Fluid Drug Concentrations.Clinical and translational science · 2025Article
- Standard versus double dosing of beta-lactam antibiotics in critically ill patients with sepsis: The BULLSEYE study protocol for a multicenter randomized controlled trial.BMC infectious diseases · 2025Article
- Therapeutic drug monitoring (TDM) of β-lactam/β-lactamase inhibitor (BL/BLI) drug combinations: insights from a pharmacometric simulation study.The Journal of antimicrobial chemotherapy · 2025Article
- Target-controlled dialysis for antibiotics (TCD-ABx).Intensive care medicine experimental · 2024Article
- Article
- Phenanthrenes fromJournal of natural products · 2024Article
- Development and Validation of a Capillary Zone Electrophoresis-Tandem Mass Spectrometry Method for Simultaneous Quantification of Eight β-Lactam Antibiotics and Two β-Lactamase Inhibitors in Plasma Samples.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Exploring the Impact of Model-Informed Precision Dosing on Procalcitonin Concentrations in Critically Ill Patients: A Secondary Analysis of the DOLPHIN Trial.Pharmaceutics · 2024Article
- The OPAT opportunity for beta-lactam individualization.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCritically ill patients undergo extensive physiological alterations that will have impact on antibiotic pharmacokinetics. Up to 60% of intensive care unit (ICU) patients meet the pharmacodynamic targets of beta-lactam antibiotics, with only 30% in fluoroquinolones. Not reaching these targets might increase the chance of therapeutic failure, resulting in increased mortality and morbidity, and antibiotic resistance. The DOLPHIN trial was designed to demonstrate the added value of therapeutic drug monitoring (TDM) of beta-lactam and fluoroquinolones in critically ill patients in the ICU.
methodsA multi-centre, randomised controlled trial (RCT) was designed to assess the efficacy and cost-effectiveness of model-based TDM of beta-lactam and fluoroquinolones. Four hundred fifty patients will be included within 24 months after start of inclusion. Eligible patients will be randomly allocated to either study group: the intervention group (active TDM) or the control group (non-TDM). In the intervention group dose adjustment of the study antibiotics (cefotaxime, ceftazidime, ceftriaxone, cefuroxime, amoxicillin, amoxicillin with clavulanic acid, flucloxacillin, piperacillin with tazobactam, meropenem, and ciprofloxacin) on day 1, 3, and 5 is performed based upon TDM with a Bayesian model. The primary outcome will be ICU length of stay. Other outcomes amongst all survival, disease severity, safety, quality of life after ICU discharge, and cost effectiveness will be included. DISCUSSION: No trial has investigated the effect of early TDM of beta-lactam and fluoroquinolones on clinical outcome in critically ill patients. The findings from the DOLPHIN trial will possibly lead to new insights in clinical management of critically ill patients receiving antibiotics. In short, to TDM or not to TDM?
trial registrationEudraCT number: 2017-004677-14. Sponsor protocol name: DOLPHIN. Registered 6 March 2018 . Protocol Version 6, Protocol date: 27 November 2019.
Indexed as
Identifiers
What OpenQuestion holds
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.