Severe infections can be caused by various organisms, such as bacteria or viruses, and lead to otherwise healthy people getting very unwell, sometimes needing treatment in hospital or even intensive care. For the treatment of bacterial infections to be successful, the correct antibiotics need to be given promptly. Early in the course of illness, clinicians often do not know exactly which bacteria are causing the infection. Furthermore, patients differ in terms of how their bodies process the antibiotics they are given; this means that some may get too much and others too little. This can in turn lead to some patients not being fully cured, and others coming to harm due to side effects of higher doses of these drugs. For certain types of antibiotics, clinicians are able to measure their levels in the bloodstream, which can help guide dosing. This is called therapeutic drug monitoring, and is commonly used in clinical practice. One of the problems with therapeutic drug monitoring is that it is often not available outside of regular working hours, is costly, and most importantly, provides clinicians with useful information only after a few days of treatment have already been completed. This may be too late to treat these severely ill patients with life-threatening infections, where early and appropriate treatments matter. The aim of our study, called TDM-TIME, is to look at how long it takes for blood samples to get from the patient to the laboratory to be measured, with the results then communicated back to clinicians. We are further looking to investigate whether steps can be taken to improve these timings, which would lead to shorter times until treatments can be improved. As our study is observational, we will not change anything about the treatment of our patients, but will only be measuring levels of antibiotics in their blood.
Study Type
OBSERVATIONAL
Enrollment
30
No intervention
Wythenshawe Hospital, Manchester University NHS Foundation Trust
Manchester, United Kingdom
Availability of LC-MS/MS results within two dose intervals of antimicrobial (dichotomous)
Proportion of participants within timeframe for antimicrobial
Time frame: 48 hours
Time elapsed from peripheral blood collection to LC-MS/MS result availability
Mean time required for result availability
Time frame: 48 hours
Time elapsed from first dose of antimicrobial to LC-MS/MS result availability
Mean time required for result availability from first antimicrobial dose administration
Time frame: 72 hours
Duration of pre-analytical stage
Mean time required for pre-analytical stage
Time frame: 24 hours
Duration of analytical stage
Mean time required for analytical stage
Time frame: 24 hours
Duration of post-analytical stage
Mean time required for post-analytical stage
Time frame: 24 hours
Therapeutic target attainment (100% fT>4xMIC)
Proportion of patients attaining target (100% fT\>4xMIC)
Time frame: 72 hours
28-day mortality
Proportion of patients alive at 28 days from enrolment
Time frame: 28 days
ICU length of stay
Number of days from ICU admission to discharge
Time frame: 28 days
Hospital length of stay
Number of days from hospital admission to discharge
Time frame: 28 days
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