Therapeutic drug monitoring of antiinfectives in intensive care patients is an usual research topic of the last years. Based on research result, which have shown subtherapeutic plasma concentrations of antibiotics, a routines therapeutic drug monitoring for β-lactam-antibiotics was implemented in January 2018 at Clinic for Anesthesiology at University Hospital, LMU Munich, Germany. This study is an prospective evaluation of these TDM-program.
Bacterial infections are associated with high mortality in intensive care patients. Antibiotic therapy is the only causal opportunity to treat those infections. Pharmacokinetic and -dynamic changes in critically ill patients lead to unpredictable plasma concentrations of the applied drugs. Research results of the last years with many quantified plasma concentrations in subtherapeutic levels yield to the recommendation of the Paul-Ehrlich-Society for an routines therapeutic drug monitoring of antibiotics in intensive care patients. These was implemented in January 2018 at Clinic for Anesthesiology at University Hospital, LMU Munich, Germany for all intensive care patients as a routines procedure. The introduced study is a prospective evaluation of the TDM-program with regard to improvement opportunity, influencing factors and parallels to other studies.
Study Type
OBSERVATIONAL
Enrollment
500
Department of Anaesthesiology of the University Hospital of Munich
Munich, Germany
Incidence of subtherapeutic antiinfective concentrations
Number of subtherapeutic concentrations from different antiinfectives in critically ill patients
Time frame: four years
Correlation of meropenem concentration in serum to the concentration in brain fluid
The concentration of meropenem in the brain fluid of 30 patients with an external ventricular drainage will be correlated to their serum concentration
Time frame: during the treatment with an external ventricular drainage
Subtherapeutic antiinfective concentrations during hemoadsorption
Subtherapeutic concentrations of antiinfectives in serum during hemoadsorption treatment
Time frame: during hemoadsorption treatment
28-day mortality of patients with therapeutic drug monitoring of antiinfectives
Correlation of antiinfective concentrations in serum to 28-day mortality
Time frame: during intensive care treatment
ICU-free days of patients with therapeutic drug monitoring of antiinfectives
Correlation of antiinfective concentrations in serum to ICU-free days to day 28
Time frame: during intensive care treatment
Sofa-score course of patients with therapeutic drug monitoring of antiinfectives
Correlation of antiinfective concentrations in serum to sofa-score
Time frame: during the treatment with the antiinfectives
Time course of Interleukin-6 in patients with therapeutic drug monitoring of antiinfectives
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Correlation of antiinfective concentrations to Interleukin-6 in critically ill patients
Time frame: during the treatment with the antiinfectives
Time course of CRP in patients with therapeutic drug monitoring of antiinfectives
Correlation of antiinfective concentrations to CRP in critically ill patients
Time frame: during the treatment with the antiinfectives