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High target attainm...
High target attainment for beta-lactam antibiotics in intensive care unit patients when actual minimum inhibitory concentrations are applied
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- Woksepp, Hanna (author)
- Linnéuniversitetet,Institutionen för medicin och optometri (MEO),Kalmar County Hospital
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- Hällgren, Anita (author)
- Linköpings universitet,Avdelningen för mikrobiologi och molekylär medicin,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland,Linköping University
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- Borgström, S. (author)
- Department of Anaesthesia and Intensive Care, Kalmar County Hospital, Kalmar, Sweden
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- Kullberg, F. (author)
- Department of Anaesthesia and Intensive Care , Central Hospital , Växjö Sweden
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- Wimmerstedt, A. (author)
- Department of Infectious Diseases, Central Hospital, Växjö, Sweden
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- Oscarsson, Anna (author)
- Linköpings universitet,Avdelningen för läkemedelsforskning,Medicinska fakulteten,Region Östergötland, Anestesi- och intensivvårdskliniken VIN,Linköping University ; Linköping University Hospital
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- Nordlund, P. (author)
- Department of Anaesthesia and Intensive Care, Ryhov Hospital, Jönköping Sweden
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- Lindholm, M-L (author)
- Department of Anaesthesia and Intensive Care, Kalmar County Hospital, Kalmar, Sweden
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- Bonnedahl, Jonas (author)
- Department of Infectious Diseases, Kalmar County Hospital, Kalmar, Sweden
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- Brudin, L. (author)
- Department of Clinical Physiology, Kalmar County Hospital, Kalmar Sweden
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- Carlsson, Björn (author)
- Linköpings universitet,Avdelningen för läkemedelsforskning,Medicinska fakulteten,Region Östergötland, Klinisk farmakologi,Linköping University
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- Schon, T. (author)
- Kalmar County Hospital ; Linköping University
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(creator_code:org_t)
- 2016-11-04
- 2017
- English.
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In: European Journal of Clinical Microbiology and Infectious Diseases. - Heidelberg : Springer. - 0934-9723 .- 1435-4373. ; 36:3, s. 553-563
- Related links:
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http://rdcu.be/qAB9
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Patients in the intensive care unit (ICU) are at risk for suboptimal levels of beta-lactam antibiotics, possibly leading to poor efficacy. Our aim was to investigate whether the actual minimum inhibitory concentration (MIC) compared to the more commonly used arbitrary epidemiological cut-off values (ECOFFs) would affect target attainment in ICU patients on empirical treatment with broad-spectrum beta-lactam antibiotics and to identify risk factors for not reaching target. In a prospective, multicenter study, ICU patients ae18 years old and treated with piperacillin/tazobactam, meropenem, or cefotaxime were included. Clinical and laboratory data were recorded. Serum trough antibiotic levels from three consecutive days were analyzed by liquid chromatography-mass spectrometry (LC-MS). The target was defined as the free trough concentration above the MIC (100% fT(> MIC)). MICECOFF was used as the target and, when available, the actual MIC (MICACTUAL) was applied. The median age of the patients was 70 years old, 52% (58/111) were males, and the median estimated glomerular filtration rate (eGFR) was 48.0 mL/min/1.73 m(2). The rate of patients reaching 100% fT > MICACTUAL was higher (89%, 31/35) compared to the same patients using MICECOFF (60%, p = 0.002). In total, 55% (61/111) reached 100% fT > MICECOFF. Increased renal clearance was independently associated to not reaching 100% fT > MICECOFF. On repeated sampling, > 77% of patients had stable serum drug levels around the MICECOFF. Serum concentrations of beta-lactam antibiotics vary extensively between ICU patients. The rate of patients not reaching target was markedly lower for the actual MIC than when the arbitrary MIC based on the ECOFF was used, which is important to consider in future studies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- Pharmacology
- Farmakologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Woksepp, Hanna
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Hällgren, Anita
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Borgström, S.
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Kullberg, F.
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Wimmerstedt, A.
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Oscarsson, Anna
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show more...
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Nordlund, P.
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Lindholm, M-L
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Bonnedahl, Jonas
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Brudin, L.
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Carlsson, Björn
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Schon, T.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Microbiology in ...
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MEDICAL AND HEAL ...
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- Articles in the publication
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European Journal ...
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Linnaeus University
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Linköping University