Evidence map›Paper›PMID 36227686›Full record

ArticleThe Journal of antimicrobial chemotherapy2022

Application of therapeutic drug monitoring to the treatment of bacterial central nervous system infection: a scoping review.

Paul Arkell, Richard Wilson, Killian Watkins, David B Antcliffe, Mark Gilchrist, Mark Wilson, Timothy M Rawson, Alison Holmes

Open access · hybridAbstract readScoping Review
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 45% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

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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

8 authors at 3 institutions in 1 country.

Paul ArkellDepartment of Infectious Disease, Centre for Antimicrobial Optimisation, Imperial College London, Hammersmith Hospital, Du Cane Road, UK.
Richard WilsonDepartment of Infectious Disease, Centre for Antimicrobial Optimisation, Imperial College London, Hammersmith Hospital, Du Cane Road, UK.ORCID 0000-0002-3275-6932
Killian WatkinsDepartment of Infectious Disease, Centre for Antimicrobial Optimisation, Imperial College London, Hammersmith Hospital, Du Cane Road, UK.
David B AntcliffeDepartment of Infectious Disease, Centre for Antimicrobial Optimisation, Imperial College London, Hammersmith Hospital, Du Cane Road, UK.
Mark GilchristDepartment of Infectious Disease, Centre for Antimicrobial Optimisation, Imperial College London, Hammersmith Hospital, Du Cane Road, UK.
Mark WilsonDepartment of Neurosurgery, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK.
Timothy M RawsonDepartment of Infectious Disease, Centre for Antimicrobial Optimisation, Imperial College London, Hammersmith Hospital, Du Cane Road, UK.
Alison HolmesDepartment of Infectious Disease, Centre for Antimicrobial Optimisation, Imperial College London, Hammersmith Hospital, Du Cane Road, UK.
Hammersmith Hospital · GBImperial College Healthcare NHS Trust · GBUniversity of Liverpool · GB

Funding

Department of Health NIHR200646Department of Health and Social Care-funded Centre NIHR200646
6 · The paper itself

Abstract

backgroundBacterial central nervous system (CNS) infection is challenging to treat and carries high risk of recurrence, morbidity, and mortality. Low CNS penetration of antibiotics may contribute to poor clinical outcomes from bacterial CNS infections. The current application of therapeutic drug monitoring (TDM) to management of bacterial CNS infection was reviewed.

methodsStudies were included if they described adults treated for a suspected/confirmed bacterial CNS infection and had antibiotic drug concentration(s) determined that affected individual treatment.

resultsOne-hundred-and-thirty-six citations were retrieved. Seventeen manuscripts were included describing management of 68 patients. TDM for vancomycin (58/68) and the beta-lactams (29/68) was most common. Timing of clinical sampling varied widely between studies and across different antibiotics. Methods for setting individual PK-PD targets, determining parameters and making treatment changes varied widely and were sometimes unclear. DISCUSSION: Despite increasing observational data showing low CNS penetration of various antibiotics, there are few clinical studies describing practical implementation of TDM in management of CNS infection. Lack of consensus around clinically relevant CSF PK-PD targets and protocols for dose-adjustment may contribute. Standardised investigation of TDM as a tool to improve treatment is required, especially as innovative drug concentration-sensing and PK-PD modelling technologies are emerging. Data generated at different centres offering TDM should be open access and aggregated to enrich understanding and optimize application.

Indexed as

Central Nervous System InfectionsDrug MonitoringAdultAnti-Bacterial Agentsbeta-LactamsHumansVancomycinAnti-Bacterial Agentsbeta-LactamsVancomycin

Identifiers

PMID36227686
PMCPMC9704426
OpenAlexW4304991019

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.