The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients

Background – The aim of this study was to determine whether there is any pharmacokinetic and/or clinical advantage associated with the administration of beta-lactam antibiotics by prolonged infusion (PI; continuous or extended-infusion) compared to intermittent bolus (IB) dosing in critically ill p...

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Main Authors:	Abdul Aziz, Mohd. Hafiz, Roberts, Jason A., Akova, Murat, Basetti, Matteo, De Waele, Jan, Dimopoulos, George, Kaukonen, Maija, Koulenti, Despoina, Martin, Claude, Montravers, Paul, Rello, Jordi, Rhodes, Alan, Starr, Therese, Wallis, Steven C., Lipman, Jeffrey
Format:	Conference or Workshop Item
Language:	English English
Published:	2013
Subjects:	RM Therapeutics. Pharmacology
Online Access:	http://irep.iium.edu.my/36784/ http://irep.iium.edu.my/36784/ http://irep.iium.edu.my/36784/4/the_DALI.pdf http://irep.iium.edu.my/36784/7/ICAAC_2013_DALI_Poster_PI_v_IB_Finalv2.pdf

id	iium-36784
recordtype	eprints
spelling	iium-367842015-11-19T01:30:06Z http://irep.iium.edu.my/36784/ The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Akova, Murat Basetti, Matteo De Waele, Jan Dimopoulos, George Kaukonen, Maija Koulenti, Despoina Martin, Claude Montravers, Paul Rello, Jordi Rhodes, Alan Starr, Therese Wallis, Steven C. Lipman, Jeffrey RM Therapeutics. Pharmacology Background – The aim of this study was to determine whether there is any pharmacokinetic and/or clinical advantage associated with the administration of beta-lactam antibiotics by prolonged infusion (PI; continuous or extended-infusion) compared to intermittent bolus (IB) dosing in critically ill patients. Methods - This report is part of the multi-national DALI study which included 68 intensive care units (ICU) throughout Europe. This study was a pharmacokinetic point-prevalence study, that was performed to describe concentrations of 3 beta-lactam antibiotics at two specified time-points. Differences in plasma antibiotic concentrations and clinical outcomes between PI and IB were assessed by using univariate and multivariate analyses. Results – This study included 224 critically ill patients whereby 63% and 37% of them received beta-lactam antibiotics via IB and PI dosing, respectively. IB dosing was preferred for piperacillin (IB 61% vs. PI 39%) and meropenem (IB 70% vs. PI 30%). The frequency of use of PI differed significantly between countries. PI demonstrated consistently higher drug concentrations compared to IB dosing. Clinical cure (IB 66% vs. PI 62%, p = 0.63), mortality (IB 28% vs. PI 30%, p = 0.87) and infection-related mortality rates (IB 22% vs. PI 17%, p = 0.288) were similar between PI and IB. Multiple regression analyses suggested that mortality was significantly predicted by SOFA score (OR = 1.10, 95% CI 1.00-1.21) and clinical cure (OR = 0.12, 95% CI 0.06-0.28). Only SOFA score predicted clinical cure (OR = 0.89, 95% CI 0.82-0.96). Conclusions – PI of beta-lactams is as effective as the traditional IB dosing in critically ill patients. 2013 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/36784/4/the_DALI.pdf application/pdf en http://irep.iium.edu.my/36784/7/ICAAC_2013_DALI_Poster_PI_v_IB_Finalv2.pdf Abdul Aziz, Mohd. Hafiz and Roberts, Jason A. and Akova, Murat and Basetti, Matteo and De Waele, Jan and Dimopoulos, George and Kaukonen, Maija and Koulenti, Despoina and Martin, Claude and Montravers, Paul and Rello, Jordi and Rhodes, Alan and Starr, Therese and Wallis, Steven C. and Lipman, Jeffrey (2013) The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients. In: 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), 10th-13th Sept. 2013, Denver, Colorado. (Unpublished) http://www.icaaconline.com/php/icaac2013abstracts/start.htm
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	RM Therapeutics. Pharmacology
spellingShingle	RM Therapeutics. Pharmacology Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Akova, Murat Basetti, Matteo De Waele, Jan Dimopoulos, George Kaukonen, Maija Koulenti, Despoina Martin, Claude Montravers, Paul Rello, Jordi Rhodes, Alan Starr, Therese Wallis, Steven C. Lipman, Jeffrey The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients
description	Background – The aim of this study was to determine whether there is any pharmacokinetic and/or clinical advantage associated with the administration of beta-lactam antibiotics by prolonged infusion (PI; continuous or extended-infusion) compared to intermittent bolus (IB) dosing in critically ill patients. Methods - This report is part of the multi-national DALI study which included 68 intensive care units (ICU) throughout Europe. This study was a pharmacokinetic point-prevalence study, that was performed to describe concentrations of 3 beta-lactam antibiotics at two specified time-points. Differences in plasma antibiotic concentrations and clinical outcomes between PI and IB were assessed by using univariate and multivariate analyses. Results – This study included 224 critically ill patients whereby 63% and 37% of them received beta-lactam antibiotics via IB and PI dosing, respectively. IB dosing was preferred for piperacillin (IB 61% vs. PI 39%) and meropenem (IB 70% vs. PI 30%). The frequency of use of PI differed significantly between countries. PI demonstrated consistently higher drug concentrations compared to IB dosing. Clinical cure (IB 66% vs. PI 62%, p = 0.63), mortality (IB 28% vs. PI 30%, p = 0.87) and infection-related mortality rates (IB 22% vs. PI 17%, p = 0.288) were similar between PI and IB. Multiple regression analyses suggested that mortality was significantly predicted by SOFA score (OR = 1.10, 95% CI 1.00-1.21) and clinical cure (OR = 0.12, 95% CI 0.06-0.28). Only SOFA score predicted clinical cure (OR = 0.89, 95% CI 0.82-0.96). Conclusions – PI of beta-lactams is as effective as the traditional IB dosing in critically ill patients.
format	Conference or Workshop Item
author	Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Akova, Murat Basetti, Matteo De Waele, Jan Dimopoulos, George Kaukonen, Maija Koulenti, Despoina Martin, Claude Montravers, Paul Rello, Jordi Rhodes, Alan Starr, Therese Wallis, Steven C. Lipman, Jeffrey
author_facet	Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Akova, Murat Basetti, Matteo De Waele, Jan Dimopoulos, George Kaukonen, Maija Koulenti, Despoina Martin, Claude Montravers, Paul Rello, Jordi Rhodes, Alan Starr, Therese Wallis, Steven C. Lipman, Jeffrey
author_sort	Abdul Aziz, Mohd. Hafiz
title	The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients
title_short	The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients
title_full	The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients
title_fullStr	The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients
title_full_unstemmed	The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients
title_sort	dali study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients
publishDate	2013
url	http://irep.iium.edu.my/36784/ http://irep.iium.edu.my/36784/ http://irep.iium.edu.my/36784/4/the_DALI.pdf http://irep.iium.edu.my/36784/7/ICAAC_2013_DALI_Poster_PI_v_IB_Finalv2.pdf
first_indexed	2023-09-18T20:52:44Z
last_indexed	2023-09-18T20:52:44Z
_version_	1777410102217670656

The DALI study: defining antibiotic levels in intensive care unit patients: prolonged infusion of beta-lactam antibiotics in critically ill patients

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