Evidence map›Paper›PMID 41339879›Full record

ArticleJournal of anesthesia, analgesia and critical care2025

Validation of a predictive risk score of aggressive PK/PD target non-attainment with continuous infusion piperacillin/tazobactam or meropenem in critically ill patients having documented Gram-negative infections.

Milo Gatti, Pierantonio Grimaldi, Matteo Rinaldi, Antonio Siniscalchi, Tommaso Tonetti, Pierluigi Viale, Federico Pea

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In one paragraph

Article in Journal of anesthesia, analgesia and critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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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

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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

1 citing paper in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Milo Gatti *Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy. milo.gatti2@unibo.it.
Pierantonio Grimaldi *Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Matteo RinaldiDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Antonio SiniscalchiAnesthesia and Intensive Care Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Tommaso TonettiDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Pierluigi VialeDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Federico PeaDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo validate a predictive risk score of early aggressive pharmacokinetic/pharmacodynamic (PK/PD) target non-attainment with continuous infusion (CI) piperacillin/tazobactam or meropenem in a retrospective cohort of critically ill patients having documented Gram-negative infections.

methodsCritically ill adult patients receiving treatment of documented Gram-negative infections with CI piperacillin-tazobactam or meropenem and undergoing first real-time beta-lactam therapeutic drug monitoring (TDM) instance within 72 h from starting standard dosing regimens were retrospectively included. A receiving operating characteristic (ROC) curve analysis was performed by using the proposed predictive score as the test variable and early aggressive PK/PD target non-attainment as the state variable. Area under the curve (AUC) and 95% confidence interval were calculated. The identified cut-off risk values were used for stratifying patients and assessing the impact on clinical/microbiological outcome in each sub-cohort of patients receiving targeted monotherapy.

resultsOverall, 209 and 203 patients receiving CI piperacillin-tazobactam and meropenem were included, respectively. Early aggressive PK/PD target non-attainment was reported in 33 cases (15.8%) receiving piperacillin-tazobactam and in 8 (3.9%) of those treated with meropenem. A score threshold ≥ 2 points for piperacillin-tazobactam (AUC 0.81; 95% CI 0.75-0.86; p < 0.0001) and ≥ 3 points for patients treated with meropenem (AUC 0.96; 95% CI 0.93-0.99; p < 0.0001) were significantly associated with early aggressive PK/PD target non-attainment. Patients achieving the cut-off predictive score showed a significant higher microbiological failure rate in both piperacillin-tazobactam (56.3% vs. 28.6%, p = 0.044) and meropenem sub-cohorts (50.0% vs. 10.4%, p = 0.028).

conclusionsOur findings suggest that the proposed predictive cut-off risk score may represent a valuable tool for identifying promptly critically ill patients at high risk of early aggressive PK/PD target non-attainment with CI piperacillin-tazobactam or meropenem for whom a more intensified CI dosing regimens should be promptly applied bedside.

Indexed as

Beta-lactamsCritically ill patientsEarly aggressive PK/PD target attainmentMicrobiological failureScore validation

Identifiers

PMID41339879
PMCPMC12797542

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