DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic
Identifieur interne : 000E86 ( Ncbi/Merge ); précédent : 000E85; suivant : 000E87DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic
Auteurs : Jason A. Roberts [Australie] ; Jan J. De Waele [Belgique] ; George Dimopoulos [Grèce] ; Despoina Koulenti [Grèce] ; Claude Martin [France] ; Philippe Montravers [France] ; Jordi Rello [Espagne] ; Andrew Rhodes [Royaume-Uni] ; Therese Starr [Australie] ; Steven C. Wallis [Australie] ; Jeffrey Lipman [Australie]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2012.
Abstract
The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol.
DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics.
The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.
Url:
DOI: 10.1186/1471-2334-12-152
PubMed: 22768873
PubMed Central: 3506523
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol.</p>
</sec>
<sec><title>Methods</title>
<p>DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics.</p>
</sec>
<sec><title>Discussion</title>
<p>The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id>
<journal-title-group><journal-title>BMC Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2334</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22768873</article-id>
<article-id pub-id-type="pmc">3506523</article-id>
<article-id pub-id-type="publisher-id">1471-2334-12-152</article-id>
<article-id pub-id-type="doi">10.1186/1471-2334-12-152</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Study Protocol</subject>
</subj-group>
</article-categories>
<title-group><article-title>DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Roberts</surname>
<given-names>Jason A</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<xref ref-type="aff" rid="I2">2</xref>
<email>j.roberts2@uq.edu.au</email>
</contrib>
<contrib contrib-type="author" id="A2"><name><surname>De Waele</surname>
<given-names>Jan J</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>Jan.DeWaele@UGent.be</email>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Dimopoulos</surname>
<given-names>George</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>gdimop@med.uoa.gr</email>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>Koulenti</surname>
<given-names>Despoina</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>deskogr@yahoo.gr</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Martin</surname>
<given-names>Claude</given-names>
</name>
<xref ref-type="aff" rid="I5">5</xref>
<email>claude.martin@mail.ap-hm.fr</email>
</contrib>
<contrib contrib-type="author" id="A6"><name><surname>Montravers</surname>
<given-names>Philippe</given-names>
</name>
<xref ref-type="aff" rid="I6">6</xref>
<email>philippe.montravers@bch.ap-hop-paris.fr</email>
</contrib>
<contrib contrib-type="author" id="A7"><name><surname>Rello</surname>
<given-names>Jordi</given-names>
</name>
<xref ref-type="aff" rid="I7">7</xref>
<email>jrello@crips.es</email>
</contrib>
<contrib contrib-type="author" id="A8"><name><surname>Rhodes</surname>
<given-names>Andrew</given-names>
</name>
<xref ref-type="aff" rid="I8">8</xref>
<email>andrewrhodes@nhs.net</email>
</contrib>
<contrib contrib-type="author" id="A9"><name><surname>Starr</surname>
<given-names>Therese</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>Therese_Starr@health.qld.gov.au</email>
</contrib>
<contrib contrib-type="author" id="A10"><name><surname>Wallis</surname>
<given-names>Steven C</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>s.wallis@uq.edu.au</email>
</contrib>
<contrib contrib-type="author" id="A11"><name><surname>Lipman</surname>
<given-names>Jeffrey</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<xref ref-type="aff" rid="I2">2</xref>
<email>j.lipman@uq.edu.au</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia</aff>
<aff id="I2"><label>2</label>
Royal Brisbane and Women’s Hospital, Brisbane, Australia</aff>
<aff id="I3"><label>3</label>
Ghent University Hospital, Ghent, Belgium</aff>
<aff id="I4"><label>4</label>
Attikon University Hospital, Athens, Greece</aff>
<aff id="I5"><label>5</label>
Hospital Nord, Marseille, France</aff>
<aff id="I6"><label>6</label>
Centre Hospitalier Universitaire Bichat-Claude Bernard, AP-HP, Université Paris VII, Paris, France</aff>
<aff id="I7"><label>7</label>
Hospital Vall d’Hebron, Barcelona, Spain</aff>
<aff id="I8"><label>8</label>
St George’s Healthcare NHS Trust and St George’s University of London, London, England, UK</aff>
<pub-date pub-type="collection"><year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>6</day>
<month>7</month>
<year>2012</year>
</pub-date>
<volume>12</volume>
<fpage>152</fpage>
<lpage>152</lpage>
<history><date date-type="received"><day>11</day>
<month>4</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>28</day>
<month>6</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Copyright ©2012 Roberts et al.; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2012</copyright-year>
<copyright-holder>Roberts et al.; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.biomedcentral.com/1471-2334/12/152"></self-uri>
<abstract><sec><title>Background</title>
<p>The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol.</p>
</sec>
<sec><title>Methods</title>
<p>DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics.</p>
</sec>
<sec><title>Discussion</title>
<p>The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.</p>
</sec>
</abstract>
<kwd-group><kwd>Antibiotic</kwd>
<kwd>βeta-lactam</kwd>
<kwd>Glycopeptide</kwd>
<kwd>Triazole</kwd>
<kwd>Echinocandin</kwd>
<kwd>Continuous infusion</kwd>
<kwd>Extended infusion</kwd>
<kwd>Bolus dosing</kwd>
<kwd>Adverse events</kwd>
<kwd>Pharmacokinetics</kwd>
<kwd>Pharmacodynamics</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Australie</li>
<li>Belgique</li>
<li>Espagne</li>
<li>France</li>
<li>Grèce</li>
<li>Royaume-Uni</li>
</country>
<region><li>Angleterre</li>
<li>Attique (région)</li>
<li>Catalogne</li>
<li>Grand Londres</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Île-de-France</li>
</region>
<settlement><li>Athènes</li>
<li>Barcelone</li>
<li>Londres</li>
<li>Marseille</li>
<li>Paris</li>
</settlement>
<orgName><li>Université de Londres</li>
</orgName>
</list>
<tree><country name="Australie"><noRegion><name sortKey="Roberts, Jason A" sort="Roberts, Jason A" uniqKey="Roberts J" first="Jason A" last="Roberts">Jason A. Roberts</name>
</noRegion>
<name sortKey="Lipman, Jeffrey" sort="Lipman, Jeffrey" uniqKey="Lipman J" first="Jeffrey" last="Lipman">Jeffrey Lipman</name>
<name sortKey="Lipman, Jeffrey" sort="Lipman, Jeffrey" uniqKey="Lipman J" first="Jeffrey" last="Lipman">Jeffrey Lipman</name>
<name sortKey="Roberts, Jason A" sort="Roberts, Jason A" uniqKey="Roberts J" first="Jason A" last="Roberts">Jason A. Roberts</name>
<name sortKey="Starr, Therese" sort="Starr, Therese" uniqKey="Starr T" first="Therese" last="Starr">Therese Starr</name>
<name sortKey="Wallis, Steven C" sort="Wallis, Steven C" uniqKey="Wallis S" first="Steven C" last="Wallis">Steven C. Wallis</name>
</country>
<country name="Belgique"><noRegion><name sortKey="De Waele, Jan J" sort="De Waele, Jan J" uniqKey="De Waele J" first="Jan J" last="De Waele">Jan J. De Waele</name>
</noRegion>
</country>
<country name="Grèce"><region name="Attique (région)"><name sortKey="Dimopoulos, George" sort="Dimopoulos, George" uniqKey="Dimopoulos G" first="George" last="Dimopoulos">George Dimopoulos</name>
</region>
<name sortKey="Koulenti, Despoina" sort="Koulenti, Despoina" uniqKey="Koulenti D" first="Despoina" last="Koulenti">Despoina Koulenti</name>
</country>
<country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Martin, Claude" sort="Martin, Claude" uniqKey="Martin C" first="Claude" last="Martin">Claude Martin</name>
</region>
<name sortKey="Montravers, Philippe" sort="Montravers, Philippe" uniqKey="Montravers P" first="Philippe" last="Montravers">Philippe Montravers</name>
</country>
<country name="Espagne"><region name="Catalogne"><name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name>
</region>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Rhodes, Andrew" sort="Rhodes, Andrew" uniqKey="Rhodes A" first="Andrew" last="Rhodes">Andrew Rhodes</name>
</region>
</country>
</tree>
</affiliations>
</record>
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