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  • Therapeutic Drug Monitoring of Beta-Lactam Antibiotics in Burns Patients—A One-Year Prospective Study

    Author(s)
    M. Patel, Bhavik
    Paratz, Jennifer D.
    C. See, Natalie
    J. Muller, Michael
    Rudd, Michael
    Paterson, David
    E. Briscoe, Scott
    Ungerer, Jacobus P. J.
    McWhinney, Brett C.
    A. Roberts, Jason
    Griffith University Author(s)
    Paratz, Jenny D.
    Year published
    2012
    Metadata
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    Abstract
    Background: Beta-lactams are first-line antibiotics for the management of superficial infections due to burn injury. There is sparse data available on therapeutic drug monitoring (TDM) in patients with burns in a ward setting. This study was conducted to evaluate the utility of a beta-lactam TDM program in a cohort of burn injury patients in a ward environment. Methods: Steady-state blood samples were collected immediately before a scheduled dose. The therapeutic concentration targets assessed were (1) free antibiotic concentrations exceeding the minimum inhibitory concentration (MIC; fT > MIC) and (2) free concentrations ...
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    Background: Beta-lactams are first-line antibiotics for the management of superficial infections due to burn injury. There is sparse data available on therapeutic drug monitoring (TDM) in patients with burns in a ward setting. This study was conducted to evaluate the utility of a beta-lactam TDM program in a cohort of burn injury patients in a ward environment. Methods: Steady-state blood samples were collected immediately before a scheduled dose. The therapeutic concentration targets assessed were (1) free antibiotic concentrations exceeding the minimum inhibitory concentration (MIC; fT > MIC) and (2) free concentrations =4נMIC of the known or suspected pathogen (fT > 4נMIC). The duration of therapy was also assessed. Results: A total of 50 patients were included for TDM over a 12-month period. The mean (ᓄ) age was 49 ᠱ6 years. The mean percent total body surface area burn was 17 ᠱ3%. The mean serum creatinine concentration was 86 ᠲ0 孯le/L. Sixty percent of the patients did not achieve fT > MIC, and only 18% achieved the higher target of fT > 4נMIC. Although all the patients achieved a positive clinical outcome, the duration of antibiotic treatment was shorter in patients who achieved fT > MIC compared with those who did not (4.2 ᠱ.1 versus 5.3 ᠲ.3 days; P = 0.03). Conclusions: We found TDM to be a reliable intervention for burn injury patients in a ward environment. This study supports pharmacokinetic data that burns patients may be at risk of subtherapeutic dosing, which may prolong the duration of antibiotic therapy.
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    Journal Title
    Therapeutic Drug Monitoring
    Volume
    34
    Issue
    2
    DOI
    https://doi.org/10.1097/FTD.0b013e31824981a6
    Subject
    Physiotherapy
    Analytical Chemistry
    Pharmacology and Pharmaceutical Sciences
    Publication URI
    http://hdl.handle.net/10072/60159
    Collection
    • Journal articles

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