SaMpling Antibiotics in Renal Replacement Therapy (SMARRT).
Inadequate antimicrobial therapy is a critical determinant of survival in patients admitted to ICU, with overwhelming infection requiring renal replacement therapy (RRT). Guidelines for effective dosing are not available because RRT can be significantly different between ICUs, resulting in antimicrobial pharmacokinetics that could be inadequate in up to 40% of antimicrobial doses. Developing an evidenced based antimicrobial dosing guideline is of global significance and should be considered a priority to improving clinical outcomes for patients with significant infections requiring RRT.
The aim of the SMARRT Study is to develop optimised antimicrobial dosing guidelines for ICU patients with life-threatening infections that account for patient characteristics and the type of RRT they are prescribed. This study will focus on piperacillin/tazobactam, meropenem, vancomycin and linezolid.
Relevant Publications
Sharrok, Lucy, Ankravs, Melissa J., Deane, Adam M., Rechnitzer, Thomas, Wallis, Steven C., Roberts, Jason A. and Bellomo, Rinaldo (2023). Clearance of piperacillin-tazobactam and vancomycin during continuous renal replacement with regional citrate anticoagulation. Therapeutic Drug Monitoring, 45 (2), 265-268. doi: 10.1097/FTD.0000000000001028
Cheng, Vesa, Abdul-Aziz, Mohd H. and Roberts, Jason A. (2021). Applying antimicrobial pharmacokinetic principles for complex patients: critically ill adult patients receiving extracorporeal membrane oxygenation and renal replacement therapy. Current Infectious Disease Reports, 23 (9) 13. doi: 10.1007/s11908-021-00757-y
Antimicrobial dosing in prolonged intermittent renal replacement therapy: a systematic review
Rawlins, Matthew D. M., Misko, Jeanie and Roberts, Jason A. (2021). Antimicrobial dosing in prolonged intermittent renal replacement therapy: a systematic review. Journal of Pharmacy Practice and Research, 51 (2), 106-120. doi: 10.1002/jppr.1723
Sime, Fekade B., Pandey, Saurabh, Karamujic, Nermin, Parker, Suzanne, Alexander, Elizabeth, Loutit, Jeffery, Durso, Stephanie, Griffith, David, Lipman, Jeffrey, Wallis, Steven C. and Roberts, Jason A. (2018) Ex vivo characterisation of effects of renal replacement therapy modalities and settings on pharmacokinetics of meropenem and vaborbactam. Antimicrobial Agents and Chemotherapy, . doi:10.1128/AAC.01306-18
Kanji, Salmaan, Roberts, Jason A., Xie, Jiao, Alobaid, Abdulaziz, Zelenitsky, Sheryl, Hiremath, Swapnil, Zhang, Guijun, Watpool, Irene, Porteous, Rebecca and Patel, Rakesh (2018) Piperacillin population pharmacokinetics in critically ill adults during sustained low-efficiency dialysis. Annals of Pharmacotherapy, 106002801877377. doi:10.1177/1060028018773771
Braune, S., Ka Nig, C., Roberts, J., Nierhaus, A., Steinmetz, O., Baehr, M., . . . Langebrake, C. (2018). Pharmacokinetics of meropenem in septic patients on sustained low-efficiency dialysis: A population pharmacokinetic study. Critical Care, 22(1), Critical Care, Jan 30, 2018, Vol.22(1)
DOI: 10.1186/s13054-018-1940-1
