Roberts, Jason A

Choi, Gordon Y S

Joynt, Gavin M

Paul, Sanjoy K

Deans, Renae

Peake, Sandra

Cole, Louise

Stephens, Dianne

Bellomo, Rinaldo

Turnidge, John

Wallis, Steven C

Roberts, Michael S

Roberts, Darren M

Lassig-Smith, Melissa

Starr, Therese

Lipman, Jeffrey

2016-03-01

Optimal antibiotic dosing is key to maximising patient survival, and minimising the emergence of bacterial resistance. Evidence-based antibiotic dosing guidelines for critically ill patients receiving RRT are currently not available, as RRT techniques and settings vary greatly between ICUs and even individual patients. We aim to develop a robust, evidence-based antibiotic dosing guideline for critically ill patients receiving various forms of RRT. We further aim to observe whether therapeutic antibiotic concentrations are associated with reduced 28-day mortality. We designed a multi-national, observational pharmacokinetic study in critically ill patients requiring RRT. The study antibiotics will be vancomycin, linezolid, piperacillin/tazobactam and meropenem. Pharmacokinetic sampling of each patient's blood, RRT effluent and urine will take place during two separate dosing intervals. In addition, a comprehensive data set, which includes the patients' demographic and clinical parameters, as well as modality, technique and settings of RRT, will be collected. Pharmacokinetic data will be analysed using a population pharmacokinetic approach to identify covariates associated with changes in pharmacokinetic parameters in critically ill patients with AKI who are undergoing RRT for the five commonly prescribed antibiotics. Using the comprehensive data set collected, the pharmacokinetic profile of the five antibiotics will be constructed, including identification of RRT and other factors indicative of the need for altered antibiotic dosing requirements. This will enable us to develop a dosing guideline for each individual antibiotic that is likely to be relevant to any critically ill patient with acute kidney injury receiving any of the included forms of RRT. Australian New Zealand Clinical Trial Registry ( ACTRN12613000241730 ) registered 28 February 2013.

Burns Trauma and Critical Care Research Centre, The University of Queensland, Level 3 Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston, Queensland, 4029, Australia. j.roberts2@uq.edu.au.. Royal Brisbane & Women's Hospital, Queensland, Australia. j.roberts2@uq.edu.au..

Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China. gchoi@cuhk.edu.hk..

Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China. gavinmjoynt@cuhk.edu.hk..

Clinical Trials & Biostatistics Unit, QIMR Berghofer, Queensland, Australia. sanjoy.paul@qimrberghofer.edu.au..

Burns Trauma and Critical Care Research Centre, The University of Queensland, Level 3 Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston, Queensland, 4029, Australia. renae.deans@gmail.com..

The Queen Elizabeth Hospital, South Australia, Australia. Sandra.Peake@sa.gov.au..

Nepean Hospital, New South Wales, Australia. l.cole@sydney.edu.au..

Royal Darwin Hospital, Northern Territory, Australia. Dianne.stephens@nt.gov.au..

Austin Hospital, Victoria, Australia. Rinaldo.BELLOMO@austin.org.au..

Royal Women's and Children's Hospital, Queensland, Australia. John.Turnidge@health.sa.gov.au..

Burns Trauma and Critical Care Research Centre, The University of Queensland, Level 3 Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston, Queensland, 4029, Australia. s.wallis@uq.edu.au..

Therapeutics Research Unit, The University of Queensland, Queensland, Australia. m.roberts@uq.edu.au..

Burns Trauma and Critical Care Research Centre, The University of Queensland, Level 3 Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston, Queensland, 4029, Australia. 1darren1@gmail.com..

Royal Brisbane & Women's Hospital, Queensland, Australia. Melissa.Lassig-Smith@health.qld.gov.au..

Royal Brisbane & Women's Hospital, Queensland, Australia. Therese.Starr@health.qld.gov.au..

Burns Trauma and Critical Care Research Centre, The University of Queensland, Level 3 Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston, Queensland, 4029, Australia. j.lipman@uq.edu.au.. Royal Brisbane & Women's Hospital, Queensland, Australia. j.lipman@uq.edu.au..

BMC infectious diseases 2016-03-01; 16: 103

https://pubmed.ncbi.nlm.nih.gov/26932762/?otool=iaurydwlib

https://hdl.handle.net/10137/5376

Acute Kidney Injury

Adolescent

Adult

Aged

Aged, 80 and over

Algorithms

Anti-Bacterial Agents

Biomarkers, Pharmacological

Clinical Protocols

Critical Illness

Female

Humans

Male

Middle Aged

Sepsis

Young Adult

Renal Replacement Therapy

SaMpling Antibiotics in Renal Replacement Therapy (SMARRT): an observational pharmacokinetic study in critically ill patients.

Journal Article

Multicenter Study

Observational Study

Publication