Please use this identifier to cite or link to this item: https://hdl.handle.net/10137/5312
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dc.contributor.authorTsai, Dannyen
dc.contributor.authorStewart, Penelopeen
dc.contributor.authorGoud, Rajendraen
dc.contributor.authorGourley, Stephenen
dc.contributor.authorHewagama, Saliyaen
dc.contributor.authorKrishnaswamy, Sushenaen
dc.contributor.authorWallis, Steven Cen
dc.contributor.authorLipman, Jeffreyen
dc.contributor.authorRoberts, Jason Aen
dc.date2016en
dc.date.accessioned2018-05-15T23:00:39Zen
dc.date.available2018-05-15T23:00:39Zen
dc.date.issued2016-11en
dc.identifier.citationInternational journal of antimicrobial agents 2016-11; 48(5): 542-546en
dc.identifier.urihttps://hdl.handle.net/10137/5312en
dc.description.abstractCurrently there are no pharmacokinetic (PK) data to guide antibiotic dosing in critically ill Australian Indigenous patients with severe sepsis. This study aimed to determine whether the population pharmacokinetics of meropenem were different between critically ill Australian Indigenous and critically ill Caucasian patients. Serial plasma and urine samples as well as clinical and demographic data were collected over two dosing intervals from critically ill Australian Indigenous patients. Plasma meropenem concentrations were assayed by validated chromatography. Concentration-time data were analysed with data from a previous PK study in critically ill Caucasian patients using Pmetrics. The population PK model was subsequently used for Monte Carlo dosing simulations to describe optimal doses for these patients. Six Indigenous and five Caucasian subjects were included. A two-compartment model described the data adequately, with meropenem clearance and volume of distribution of the central compartment described by creatinine clearance (CLCr) and patient weight, respectively. Patient ethnicity was not supported as a covariate in the final model. Significant differences were observed for meropenem clearance between the Indigenous and Caucasian groups [median 11.0 (range 3.0-14.1) L/h vs. 17.4 (4.3-30.3) L/h, respectively; P <0.01]. Standard dosing regimens (1 g intravenous every 8 h as a 30-min infusion) consistently achieved target exposures at the minimum inhibitory concentration breakpoint in the absence of augmented renal clearance. No significant interethnic differences in meropenem pharmacokinetics between the Indigenous and Caucasian groups were detected and CLCr was found to be the strongest determinant of appropriate dosing regimens.en
dc.language.isoengen
dc.subjectCritically illen
dc.subjectPharmacokineticsen
dc.subjectSevere sepsisen
dc.subjectβ-Lactamen
dc.titleOptimising meropenem dosing in critically ill Australian Indigenous patients with severe sepsis.en
dc.typeJournal Articleen
dc.typeObservational Studyen
dc.identifier.journaltitleInternational journal of antimicrobial agentsen
dc.identifier.doi10.1016/j.ijantimicag.2016.08.015en
dc.identifier.pubmedidhttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed//27771187en
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshAustraliaen
dc.subject.meshEuropean Continental Ancestry Groupen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMicrobial Sensitivity Testsen
dc.subject.meshMiddle Ageden
dc.subject.meshMonte Carlo Methoden
dc.subject.meshPlasmaen
dc.subject.meshPopulation Groupsen
dc.subject.meshProspective Studiesen
dc.subject.meshSepsisen
dc.subject.meshThienamycinsen
dc.subject.meshTime Factorsen
dc.subject.meshUrineen
dc.subject.meshYoung Adulten
dc.subject.meshCritical Illnessen
dc.identifier.affiliationBurns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Intensive Care Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia; Pharmacy Department, Alice Springs Hospital, Alice Springs, Northern Territory, Australia. Electronic address: d.tsai@uq.edu.au..en
dc.identifier.affiliationDepartment of Intensive Care Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..en
dc.identifier.affiliationDepartment of Intensive Care Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..en
dc.identifier.affiliationEmergency Department, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..en
dc.identifier.affiliationDepartment of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia; Department of Infectious Diseases, The Northern Hospital, Epping, Melbourne, Victoria, Australia..en
dc.identifier.affiliationDepartment of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia; Monash Infectious Diseases, Monash Health, Clayton, Melbourne, Victoria, Australia..en
dc.identifier.affiliationBurns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia..en
dc.identifier.affiliationBurns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Intensive Care Medicine, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia..en
dc.identifier.affiliationBurns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Intensive Care Medicine, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia..en
dc.identifier.pubmedurihttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed//27771187en
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