Therapeutic drug monitoring and dose personalisation of antimicrobials in mechanically ventilated patients with Gram-negative pneumonia.

Lung infections are the most common infections in ICU patients and piperacillin/tazobactam is the most commonly prescribed empiric antimicrobial for this indication.

Given the significant pharmacokinetic variability in this special population, there is huge potential for an intervention that optimises piperacillin dosing to ensure that pharmacokinetic/dynamic targets are achieved, treatment outcomes are improved and emergence of resistance is suppressed. The use of modern pharmacokinetic software (eg. BestDose®) to individualise antimicrobial dosing to minimise emergence of resistance is novel.

The aim of this project is to investigate the feasibility of conducting a randomised trial to determine whether antimicrobial regimen individualisation will reduce the risk of bacterial resistance.

This hypothesis will be tested in mechanically ventilated ICU patients with Gram-negative pneumonia.

Relevant Publications

Treatment of ventilator-associated pneumonia due to carbapenem-resistant Gram-negative bacteria with novel agents: a contemporary, multidisciplinary ESGCIP perspective

Giacobbe, Daniele Roberto, Roberts, Jason A., Abdul-Aziz, Mohd H., de Montmollin, Etienne, Timsit, Jean-François and Bassetti, Matteo (2022). Treatment of ventilator-associated pneumonia due to carbapenem-resistant Gram-negative bacteria with novel agents: a contemporary, multidisciplinary ESGCIP perspective. Expert Review of Anti-infective Therapy, 20 (7), 1-17. doi: 10.1080/14787210.2022.2063838