ArticleOpen forum infectious diseases2023
Optimizing the Use of Beta-Lactam Antibiotics in Clinical Practice: A Test of Time.
Article in Open forum infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Therapeutic drug monitoring and the role of pharmacokinetics/pharmacodynamics in optimizing beta-lactam antibiotic dosing for deep-seated infections: a systematic review.The Journal of antimicrobial chemotherapy · 2026Pooled it
- Mortality of continuous infusion versus intermittent bolus of meropenem: a systematic review and meta-analysis of randomized controlled trials.Frontiers in microbiology · 2024Pooled it
- Population pharmacokinetic/pharmacodynamic modeling to optimize aztreonam-avibactam dose regimens for adult patients.Antimicrobial agents and chemotherapy · 2025Trial
- Rising Carbapenem MICs and Clinical Dose Optimization: Bridging Resistance Surveillance and Pharmacokinetic/Pharmacodynamic Strategies.Antibiotics (Basel, Switzerland) · 2026Review
- Mechanism-Base Pharmacokinetic-Pharmacodynamic Modeling of Cefquinome AgainstMedical sciences (Basel, Switzerland) · 2026Article
- Curiositas - Medicine in the Kitchen.The Ulster medical journal · 2026Article
- Article
- Ampicillin/Sulbactam in Combination with Ceftazidime/Avibactam Against Metallo-β-Lactamase-Producing Carbapenem-Resistant Acinetobacter baumannii: A Genomics-Informed Mechanism-based model.The Journal of infectious diseases · 2026Article
- Impact of a Pharmacist-Driven Penicillin Allergy De-Labeling Service (PADLS) on Hospitalized Patients.Pharmacy (Basel, Switzerland) · 2026Article
- Optimal Piperacillin/Tazobactam Dosing in Adults with Low Body Weight: A Population Pharmacokinetic and Simulation-Based Study.Drug design, development and therapy · 2026Observational
- Letter to editor:prolonged versus short-term infusion of meropenem for the treatment of sepsis: a systematic review and meta-analysis.International journal of surgery (London, England) · 2025Article
- Molecular and pharmacodynamic insights into β-lactam therapy for high-inoculumAntimicrobial agents and chemotherapy · 2025Article
- Effectiveness of piperacillin/tazobactam loading dose for extended infusion dosing among patients with Gram-negative bacteraemia.The Journal of antimicrobial chemotherapy · 2025Article
- Optimising Meropenem and Piperacillin Dosing in Patients Undergoing Extracorporeal Membrane Oxygenation Without Renal Dysfunction (MEPIMEX).Antibiotics (Basel, Switzerland) · 2025Article
- Optimising Regimen of Co-Amoxiclav (ORCA)-The Safety and Efficacy of Intravenous Co-Amoxiclav at Higher Dosing Frequency in Patients with Diabetic Foot Infection.Antibiotics (Basel, Switzerland) · 2025Article
- The Changing Landscape of Antibiotic Treatment: Reevaluating Treatment Length in the Age of New Agents.Antibiotics (Basel, Switzerland) · 2025Review
- Translating Pharmacokinetic-Pharmacodynamic Principles Into Improved Methodology for Clinical Trials That Compare Intermittent With Prolonged Infusion of Beta-Lactam Antibiotics.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- First dose target attainment with extended infusion regimens of piperacillin and meropenem.Critical care (London, England) · 2025Article
- Higher target attainment for B-lactam antibiotics in patients with Gram-negative bloodstream infections when four times actual minimum inhibitory concentrations and epidemiological cutoff values are applied compared to clinical breakpoints.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Antibiotic dosing optimization in critically ill patients.Intensive care medicine · 2025Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite their limitations, the pharmacokinetics (PK) and pharmacodynamics (PD) indices form the basis for our current understanding regarding antibiotic development, selection, and dose optimization. Application of PK-PD in medicine has been associated with better clinical outcome, suppression of resistance, and optimization of antibiotic consumption. Beta-lactam antibiotics remain the cornerstone for empirical and directed therapy in many patients. The percentage of time of the dosing interval that the free (unbound) drug concentration remains above the minimal inhibitory concentration (MIC) (%fT > MIC) has been considered the PK-PD index that best predicts the relationship between antibiotic exposure and killing for the beta-lactam antibiotics. Time dependence of beta-lactam antibiotics has its origin in the acylation process of the serine active site of penicillin-binding proteins, which subsequently results in bacteriostatic and bactericidal effects during the dosing interval. To enhance the likelihood of target attainment, higher doses, and prolonged infusion strategies, with/or without loading doses, have been applied to compensate for subtherapeutic levels of antibiotics related to PK-PD changes, especially in the early phase of severe sepsis. To minimize resistance and maximize clinical outcome, empirical therapy with a meropenem loading dose followed by high-dose-prolonged infusion should be considered in patients with high inoculum infections presenting as severe (Gram negative) sepsis. Subsequent de-escalation and dosing of beta-lactam antibiotics should be considered as an individualized dynamic process that requires dose adjustments throughout the time course of the disease process mediated by clinical parameters that indirectly assess PK-PD alterations.
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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.