An international survey on aminoglycoside practices in critically ill patients: the AMINO III study.
Aminoglycoside
Antibiotics
ICU
PK/PD
Therapeutic drug monitoring
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
19 Mar 2021
19 Mar 2021
Historique:
received:
29
12
2020
accepted:
05
03
2021
entrez:
19
3
2021
pubmed:
20
3
2021
medline:
20
3
2021
Statut:
epublish
Résumé
While aminoglycosides (AG) have been used for decades, debate remains on their optimal dosing strategy. We investigated the international practices of AG usage specifically regarding dosing and therapeutic drug monitoring (TDM) in critically ill patients. We conducted a prospective, multicentre, observational, cohort study in 59 intensive-care units (ICUs) in 5 countries enrolling all ICU patients receiving AG therapy for septic shock. We enrolled 931 septic ICU patients [mean ± standard deviation, age 63 ± 15 years, female 364 (39%), median (IQR) SAPS II 51 (38-65)] receiving AG as part of empirical (761, 84%) or directed (147, 16%) therapy. The AG used was amikacin in 614 (66%), gentamicin in 303 (33%), and tobramycin in 14 (1%) patients. The median (IQR) duration of therapy was 2 (1-3) days, the number of doses was 2 (1-2), the median dose was 25 ± 6, 6 ± 2, and 6 ± 2 mg/kg for amikacin, gentamicin, and tobramycin respectively, and the median dosing interval was 26 (23.5-43.5) h. TDM of C Short courses of high AG doses are mainly used in ICU patients with septic shock, although wide variability in AG usage is reported. We could show no correlation between PK/PD target attainment and clinical outcome. Efforts to optimize the first AG dose remain necessary. Trial registration Clinical Trials, NCT02850029, registered on 29th July 2016, retrospectively registered, https://www.clinicaltrials.gov.
Sections du résumé
BACKGROUND
BACKGROUND
While aminoglycosides (AG) have been used for decades, debate remains on their optimal dosing strategy. We investigated the international practices of AG usage specifically regarding dosing and therapeutic drug monitoring (TDM) in critically ill patients. We conducted a prospective, multicentre, observational, cohort study in 59 intensive-care units (ICUs) in 5 countries enrolling all ICU patients receiving AG therapy for septic shock.
RESULTS
RESULTS
We enrolled 931 septic ICU patients [mean ± standard deviation, age 63 ± 15 years, female 364 (39%), median (IQR) SAPS II 51 (38-65)] receiving AG as part of empirical (761, 84%) or directed (147, 16%) therapy. The AG used was amikacin in 614 (66%), gentamicin in 303 (33%), and tobramycin in 14 (1%) patients. The median (IQR) duration of therapy was 2 (1-3) days, the number of doses was 2 (1-2), the median dose was 25 ± 6, 6 ± 2, and 6 ± 2 mg/kg for amikacin, gentamicin, and tobramycin respectively, and the median dosing interval was 26 (23.5-43.5) h. TDM of C
CONCLUSION
CONCLUSIONS
Short courses of high AG doses are mainly used in ICU patients with septic shock, although wide variability in AG usage is reported. We could show no correlation between PK/PD target attainment and clinical outcome. Efforts to optimize the first AG dose remain necessary. Trial registration Clinical Trials, NCT02850029, registered on 29th July 2016, retrospectively registered, https://www.clinicaltrials.gov.
Identifiants
pubmed: 33740157
doi: 10.1186/s13613-021-00834-4
pii: 10.1186/s13613-021-00834-4
pmc: PMC7979853
doi:
Types de publication
Journal Article
Langues
eng
Pagination
49Investigateurs
Bruno Darchy
(B)
Lasocki Sigismond
(L)
Karim Debbat
(K)
Sébastien Moschietto
(S)
Gilles Capellier
(G)
Matthieu Biais
(M)
Guillaume Brunin
(G)
Olivier Huet
(O)
Marie-Hélène Hausermann
(MH)
Bernard Just
(B)
Jean-Michel Constantin
(JM)
Jean-François Payen
(JF)
Géraldine Dessertaine
(G)
Pierre Lavagne
(P)
Arnaud Winer
(A)
Olivier Lesieur
(O)
Mickaël Landais
(M)
Arnaud Friggeri
(A)
Jules Piclet
(J)
Bruno Pastène
(B)
Jacques Albanèse
(J)
Jérémy Bourenne
(J)
Frédéric Bellec
(F)
Samir Jaber
(S)
Pierre Egreteau
(P)
Marie-Reine Losser
(MR)
Karim Asehnoune
(K)
Karim Lakhal
(K)
Carole Ichai
(C)
Bernard Goubaux
(B)
Laurent Muller
(L)
Caroline Boutin
(C)
Matthieu Legrand
(M)
Julien Amour
(J)
Philippe Montravers
(P)
David Marrache
(D)
Walter Picard
(W)
Claire Dahyot-Fizelier
(C)
Joël Cousson
(J)
Philippe Seguin
(P)
Pascal Beuret
(P)
Arnaud Delahaye
(A)
Benoit Veber
(B)
Jérôme Morel
(J)
Ali Mofredj
(A)
Nicolas Barbarot
(N)
Bernard Georges
(B)
Henri Faure
(H)
Pierre Saint Léger
(PS)
Iouri Banakh
(I)
Jeffrey Lipman
(J)
Paul Williams
(P)
Manimozhi Vellaichamy
(M)
Maria Downey
(M)
Ruth Rosales
(R)
Roberto Amador
(R)
Daniel Muñoz
(D)
Marcial Cariqueo
(M)
Metaxia Papanikolaou
(M)
Anna Spring
(A)
Evdoxia Tsigou
(E)
Vasilios Koulouras
(V)
Polychronis Tasioudis
(P)
Greg Barton
(G)
Emma Graham Clarke
(EG)
Richard Bourne
(R)
Mark Borthwick
(M)
Mark Tomlin
(M)
Emma Boxall
(E)
Catherine Mc Kenzie
(CM)
Ruth Roadley-Battin
(R)
Timothy Felton
(T)
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