Early β-lactam concentrations and infectious complications after lung transplantation.
antibiotic drug resistance
antibiotic prophylaxis
clinical research / practice
critical care / intensive care management
health services and outcomes research
infection and infectious agents - bacterial
infectious disease
lung transplantation / pulmonology
pharmacokinetics / pharmacodynamics
pharmacology
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
27
11
2020
received:
17
06
2020
accepted:
30
11
2020
pubmed:
22
4
2021
medline:
10
8
2021
entrez:
21
4
2021
Statut:
ppublish
Résumé
Antibiotic underdosing in prophylactic antibiotic regimes after lung transplantation (LTx) can increase the risk of infection. We aimed to study whether β-lactam concentrations achieved desirable pharmacodynamic targets in the early phase after LTx and the association between drug concentrations and the development of early infections or the acquisition of multidrug-resistant (MDR) strains. We reviewed patients in whom broad-spectrum β-lactam levels were measured after LTx during antibiotic prophylaxis. β-Lactam concentrations were considered "insufficient" if drug levels remained below four times the clinical breakpoint of the minimal inhibitory concentration for Pseudomonas aeruginosa. The primary outcome was the occurrence of an infection and/or acquisition of MDR pathogens in the first 14 days after transplantation. A total of 70 patients were included. "Insufficient" drug concentrations were found in 40% of patients. In 27% of patients, an early MDR pathogen was identified and 49% patients were diagnosed with an early posttransplant infection. Patients with "insufficient" drug concentrations acquired more frequently MDR bacteria and/or developed an infection than others (22/28, 79% vs. 20/42, 48% - p = .01). β-Lactam levels were often found to be below the desired drug targets in the early phase after transplantation and may be associated with the occurrence of early infectious complications.
Identifiants
pubmed: 33880877
doi: 10.1111/ajt.16432
pii: S1600-6135(22)08636-1
doi:
Substances chimiques
Anti-Bacterial Agents
0
beta-Lactams
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2489-2497Informations de copyright
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
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