DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic

BMC Infectious Diseases

Study Protocol

Despoina Koulenti¹  George Dimopoulos¹  Steven C Wallis²  Jeffrey Lipman³  Jason A Roberts³  Philippe Montravers⁴  Jan J De Waele⁵  Claude Martin⁶  Jordi Rello⁷  Therese Starr⁸  Andrew Rhodes⁹ 

[1] Attikon University Hospital, Athens, Greece;Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia;Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia;Royal Brisbane and Women’s Hospital, Brisbane, Australia;Centre Hospitalier Universitaire Bichat-Claude Bernard, AP-HP, Université Paris VII, Paris, France;Ghent University Hospital, Ghent, Belgium;Hospital Nord, Marseille, France;Hospital Vall d’Hebron, Barcelona, Spain;Royal Brisbane and Women’s Hospital, Brisbane, Australia;St George’s Healthcare NHS Trust and St George’s University of London, London, England, UK;

关键词: Antibiotic;    βeta-lactam;    Glycopeptide;    Triazole;    Echinocandin;    Continuous infusion;    Extended infusion;    Bolus dosing;    Adverse events;    Pharmacokinetics;    Pharmacodynamics;   

DOI  :  10.1186/1471-2334-12-152

 received in 2012-04-11, accepted in 2012-06-28,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol.MethodsDALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics.DiscussionThe DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

【 授权许可】

CC BY   
© Roberts et al.; licensee BioMed Central Ltd. 2012