ArticleJournal of intensive care2020
The higher the better? Defining the optimal beta-lactam target for critically ill patients to reach infection resolution and improve outcome.
Article in Journal of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03985605 (Therapeutic Drug Monitoring of Antiinfectives for Patients With Severe Illness), which is not on this map. Cited by 43 papers, 3 of them syntheses that pooled it.
What it found
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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.
Therapeutic Drug Monitoring of Antiinfectives for Patients With Severe Illness
Who cites it
43 citing papers in PubMed, 3 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
- 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
- A novel meropenem dosing strategy for Outpatient Parenteral Antimicrobial Therapy (OPAT): a pilot pharmacokinetic/pharmacodynamic study in non-critically ill patients.Antimicrobial agents and chemotherapy · 2026Article
- Comparative efficacy and safety of extended versus continuous infusion of beta-lactam antibiotics for severe infection: a network meta-analysis of randomized trials.Critical care (London, England) · 2026Article
- Achieving target plasma concentrations of beta-lactam antibiotics in critically ill patients: a retrospective study of full-dose administration in the first 24 hours.Pharmacological reports : PR · 2026Observational
- When Culture Results Don't Tell the Whole Story: A Practical Review of Antibiotics Pitfalls for Clinical Decision-Making.Infectious diseases and therapy · 2026Review
- Development and validation of a machine learning model for individualised meropenem dosing in CRRT patients.Scientific reports · 2026Article
- Model-Informed Ceftazidime-Avibactam Dosing Stratified by Renal Function and Renal Replacement Therapy Status in Critically Ill Patients: A Prospective Population Pharmacokinetic and Monte Carlo Simulation Study.Drug design, development and therapy · 2026Article
- Effects of extracorporeal membrane oxygenation and/or renal replacement therapy on piperacillin/tazobactam levels in critically ill patients.Frontiers in pharmacology · 2026Article
- Piperacillin dosing in pediatric patients and augmented renal clearance: are current guidelines sufficient to achieve therapeutic concentration coverage?The Journal of antimicrobial chemotherapy · 2025Article
- Population pharmacokinetics of imipenem and target attainment of pharmacokinetic/pharmacodynamic indices in Chinese adults with febrile neutropenia and hematological malignancies.International journal of clinical pharmacy · 2025Article
- β-Lactam/β-Lactamase Inhibitor Combinations in Sepsis-Associated Acute Kidney Injury and Renal Replacement Therapy.Antibiotics (Basel, Switzerland) · 2025Review
- Piperacillin reaches high concentrations in bile and target tissues of the biliary system: an experimental study in pigs.Antimicrobial agents and chemotherapy · 2025Article
- Optimising Meropenem and Piperacillin Dosing in Patients Undergoing Extracorporeal Membrane Oxygenation Without Renal Dysfunction (MEPIMEX).Antibiotics (Basel, Switzerland) · 2025Article
- Practical utility of meropenem therapeutic drug monitoring: a systematic review of evidence for clinical application.Frontiers in pharmacology · 2025Article
- Systemic antibiotic prophylaxis in arthroplasty - a narrative review of how many doses are optimal.EFORT open reviews · 2024Review
- A narrative review on antimicrobial dosing in adult critically ill patients on extracorporeal membrane oxygenation.Critical care (London, England) · 2024Review
- Precision Dosing of Meropenem in Adults with Normal Renal Function: Insights from a Population Pharmacokinetic and Monte Carlo Simulation Study.Antibiotics (Basel, Switzerland) · 2024Article
- Risk Factors Associated with Antibiotic Exposure Variability in Critically Ill Patients: A Systematic Review.Antibiotics (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesBeta-lactam antibiotics are often subject to therapeutic drug monitoring, but breakpoints of target attainment are mostly based on expert opinions. Studies that show a correlation between target attainment and infection resolution are missing. This analysis investigated whether there is a difference in infection resolution based on two breakpoints of target attainment.
methodsAn outcome group out of 1392 critically ill patients treated with meropenem or piperacillin-tazobactam was formed due to different selection criteria. Afterwards, three groups were created: group 1=free drug concentration (f) was < 100% of the time (T) above the minimal inhibitory concentration (MIC) (< 100% fT >
resultsThe outcome group consisted of 55 patients (groups 1-3, 17, 24, and 14 patients, respectively). Patients allocated to group 2 or 3 had a significantly faster reduction of the C-reactive protein in contrast to patients allocated to group 1 (p = 0.033 and p = 0.026). Patients allocated to group 3 had a worse renal function, a higher Acute Physiology and Chronic Health Evaluation (APACHE II) score, were older, and had a significantly higher in-hospital mortality compared to group 1 (p = 0.017) and group 2 (p = 0.001). The higher mortality was significantly influenced by worse liver function, higher APACHE II, and higher Sequential Organ Failure Assessment (SOFA) score and norepinephrine therapy.
conclusionAchieving the target 100% fT >
trial registrationNCT03985605.
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