Population pharmacokinetics of daptomycin in critically ill patients

Soraluce, Amaia; Asín-Prieto, Eduardo; Rodríguez-Gascón, Alicia; Barrasa, Helena; Maynar, Javier; Carcelero, Esther; Soy, Dolors; Isla, Arantxazu

doi:10.1016/j.ijantimicag.2018.03.008

Cited by 37 publications

(33 citation statements)

References 31 publications

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“…Renal failure and renal replacement therapies (RRTs), cause plasma concentration changes and affect drug concentrations [5]. RRTs, especially the continuous type, have also been shown to cause significant pharmacokinetic changes on the antibiotic groups that were evaluated in this work [22][23][24]. Therefore, antibiotic doses may remain suboptimal in ICU patients when compared to the normal population [5,25,26]..…”

Section: Discussionmentioning

confidence: 99%

Inapropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Inapropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Inapropriate Use of Antibiotics Effective Against Gram Positive Microorganisms Despite Restrictive Antibiotic Policies in ICUs: A Prospective Observational Study

Özger

Fakıoğlu

Erbay

et al. 2020

Preprint

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Background: Gram-positive spectrum antibiotics such as vancomycin, teicoplanin, daptomycin, and linezolid are frequently used in empirical treatment combinations in critically ill patients. Such inappropriate and unnecessary widespread use, leads to sub-optimal utilisation. However they are covered by the antibiotics restriction programme. This prospective observational study, evaluates gram-positive anti-bacterial utilisations in intensive care units (ICUs) with various evaluation criteria, to determine the frequency of inappropriate usage and the intervention targets required to ensure optimum use. Methods: This clinical study was conducted prospectively between 01.10.2018 and 01.10.2019 in the medical and surgical ICUs of Gazi University Faculty of Medicine Hospital, Turkey. The total bed capacity was 55. Patients older than 18 years and who were prescribed gram-positive spectrum antibiotics (vancomycin, teicoplanin, linezolid, and daptomycin) were included. Patients under this age or immunosuppressed patients (neutropenic,- HIV-infected patients with hematologic or solid organ malignancies) were not included in the study. During the study period, 200 treatments were evaluated in 169 patients. The demographic and clinical features of the patients were recorded. Besides observations by the clinical staff, the treatments were recorded and evaluated by two infectious diseases specialists and two clinical pharmacists at 24-h intervals from the first day to the last day of treatment. SPSS software for Windows, (version 17, IBM, Armonk, NY) was used to analyse the data. Categorical variables were presented as number and percentage, and non-categorical variables were presented as mean ± standard deviation. Results: It was found that inappropriate gram-positive antibiotic use in ICUs was as high as 83% in terms of non-compliance with the selected quality parameters. Multivariate analysis was performed to evaluate the factors associated with inappropriate antibiotic use, increased creatinine levels were found to increase the risk of such use. Conclusions: In spite of the restricted antibiotics programme, inappropriate antibiotic use in ICUs is quite common. Thus, it is necessary to establish local guidelines in collaboration with different disciplines for the determination and follow-up of de-escalation of such use and optimal treatment doses. Keywords: Antibiotic stewardship, rational antibiotic use, antibiotic resistance, gram positive microorganisms, inappropriate antibiotic use

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“…Renal failure and renal replacement therapies cause plasma concentration changes and affect drug concentrations [5]. Renal replacement therapies (RRT), especially continuous RRT, have also been shown to cause significant pharmacokinetic changes on the antibiotic groups we evaluated [30][31][32]. Therefore, antibiotic doses may remain suboptimal in ICU patients when compared to the normal population.…”

Section: Discussionmentioning

confidence: 99%

Inapropriate Use of Antibiotics Effective Against Gram Positive Microorganism in Under Restrictive Antibiotic Policies in ICU; A Prospective Observational Study

Özger

Fakıoğlu

Erbay

et al. 2020

Preprint

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Background Gram-positive spectrum antibiotics such as vancomycin, teicoplanin, daptomycin ,and linezolid are frequently used in empirical treatment combinations in critically ill patients Although they are included in the national antibiotic restriction program, thought to be inappropriate, unnecessary and suboptimal use is high due to their widespread use. In our study, in addition to their widespread use, gram-positive spectrum antibiotics were evaluated due to their use in more limited and clear clinical indications. This study aims to determine the frequency of inappropriate uses of gram-positive spectrum antibiotics and risk factors for inappropriate use according to different quality parameters. Methods This clinical study was conducted prospectively between 01.10.2018 and 01.10.2019 in the medical and surgical ICUs of Gazi University Faculty of Medicine Hospital with a total bed capacity of 55. Patients older than 18 years of age onset of gram-positive spectrum antibiotics (vancomycin, teicoplanin, linezolid ,and daptomycin) were included. Patients under the age of eighteen or immunosuppressed (neutropenic, HIV-infected patients with hematologic or solid organ malignancies) were not included in the study. The demographic and clinical features of the patients were recorded. The treatment was also evaluated and recorded by 2 infectious diseases specialists and 2 clinical pharmacists except for the clinical staff at 24-hour intervals from the first day to the last day of treatment. SPSS software for Windows, version 17 (IBM, Armonk, NY) was used to analyze the data. Categorical variables are presented as number and percentage, and non-categorical variables are presented as mean ± standard deviation. Results In the use of antibiotics, the incidence of non-compliance with at least one of the determined quality parameters was 83%. Multivariate analysis was performed to evaluate risk factors for inappropriate antibiotic use, and creatine values were found to increase the risk of inappropriate antibiotic use. Conclusions In spite of the restricted antibiotic program, inappropriate antibiotic use in ICUs is quite common. In particular, it is necessary to establish local guidelines in collaboration with different disciplines for the determination and follow-up of de-escalation and optimal treatment doses Keywords:Antibiotic stewardship, rational antibiotic use, antibiotic resistance, gram positive microorganism, inapropriate use of antibiotics

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Population pharmacokinetics of daptomycin in critically ill patients

Cited by 37 publications

References 31 publications

Inapropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study

Inapropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study

Inapropriate Use of Antibiotics Effective Against Gram Positive Microorganisms Despite Restrictive Antibiotic Policies in ICUs: A Prospective Observational Study

Inapropriate Use of Antibiotics Effective Against Gram Positive Microorganism in Under Restrictive Antibiotic Policies in ICU; A Prospective Observational Study

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