Effect of therapeutic drug monitoring-based dose optimisation in sepsis patients
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Growing evidence suggests that insufficient antibiotic exposure (defined as failure to achieve the pharmacokinetic/pharmacodynamic (PK/PD) target to kill or inhibit the growth of a pathogen) is associated with worse clinical outcomes in sepsis patients.
Moreover, up to 50% of critically ill patients receiving a β-lactam antibiotic with regimens based on manufacturers’ recommendations fail to reach the target.
Therapeutic drug monitoring (TDM)-guided therapy has been proposed as a strategy to further optimise the achievement of the PK/PD target of β-lactam antibiotics. However, there are no data on whether piperacillin/tazobactam TDM can improve clinical outcomes.
In this context, a large RCT was performed to investigate whether TDM-based dose optimisation versus fixed dosing could improve clinical outcomes in patients with sepsis treated with piperacillin/tazobactam as a continuous infusion.
Dr Hagel shares with us the results of this study published in the ICM Journal.