| Title |
Does Beta-lactam Pharmacokinetic Variability in Critically Ill Patients Justify Therapeutic Drug Monitoring? A Systematic Review
|
|---|---|
| Published in |
Annals of Intensive Care, July 2012
|
| DOI | 10.1186/2110-5820-2-35 |
| Pubmed ID | |
| Authors |
Fekade Bruck Sime, Michael S Roberts, Sandra L Peake, Jeffrey Lipman, Jason A Roberts |
| Abstract |
The pharmacokinetics of beta-lactam antibiotics in intensive care patients may be profoundly altered due to the dynamic, unpredictable pathophysiological changes that occur in critical illness. For many drugs, significant increases in the volume of distribution and/or variability in drug clearance are common. When "standard" beta-lactam doses are used, such pharmacokinetic changes can result in subtherapeutic plasma concentrations, treatment failure, and the development of antibiotic resistance. Emerging data support the use of beta-lactam therapeutic drug monitoring (TDM) and individualized dosing to ensure the achievement of pharmacodynamic targets associated with rapid bacterial killing and optimal clinical outcomes. The purpose of this work was to describe the pharmacokinetic variability of beta-lactams in the critically ill and to discuss the potential utility of TDM to optimize antibiotic therapy through a structured literature review of all relevant publications between 1946 and October 2011. Only a few studies have reported the utility of TDM as a tool to improve beta-lactam dosing in critically ill patients. Moreover, there is little agreement between studies on the pharmacodynamic targets required to optimize antibiotic therapy. The impact of TDM on important clinical outcomes also remains to be established. Whereas TDM may be theoretically rational, clinical studies to assess utility in the clinical setting are urgently required. |
Mendeley readers
The data shown below were compiled from readership statistics for 166 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 1% |
| Germany | 1 | <1% |
| France | 1 | <1% |
| Colombia | 1 | <1% |
| South Africa | 1 | <1% |
| Brazil | 1 | <1% |
| Spain | 1 | <1% |
| Canada | 1 | <1% |
| Unknown | 157 | 95% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 25 | 15% |
| Researcher | 24 | 14% |
| Student > Ph. D. Student | 24 | 14% |
| Other | 15 | 9% |
| Student > Bachelor | 13 | 8% |
| Other | 34 | 20% |
| Unknown | 31 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 69 | 42% |
| Pharmacology, Toxicology and Pharmaceutical Science | 28 | 17% |
| Agricultural and Biological Sciences | 8 | 5% |
| Chemistry | 6 | 4% |
| Engineering | 5 | 3% |
| Other | 13 | 8% |
| Unknown | 37 | 22% |
Attention Score in Context
This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 October 2016.
All research outputs
#5,615,312
of 22,673,450 outputs
Outputs from Annals of Intensive Care
#514
of 1,033 outputs
Outputs of similar age
#39,387
of 164,533 outputs
Outputs of similar age from Annals of Intensive Care
#7
of 22 outputs
Altmetric has tracked 22,673,450 research outputs across all sources so far. Compared to these this one has done well and is in the 75th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,033 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.5. This one has gotten more attention than average, scoring higher than 50% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 164,533 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 76% of its contemporaries.
We're also able to compare this research output to 22 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.