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

Clearance of piperacillin-tazobactam and vancomycin during continuous renal replacement with regional citrate anticoagulation

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

Applying antimicrobial pharmacokinetic principles for complex patients: critically ill adult patients receiving extracorporeal membrane oxygenation and renal replacement therapy

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

Project members

Jason Roberts

Professor Jason Roberts

Director
CRE RESPOND
Acting Director
UQ Centre for Clinical Research
NHMRC Leadership Fellow
The University of Queensland
Pharmacist Consultant
Royal Brisbane & Women’s Hospital

Professor Jeffrey Lipman

Critical Care Research, Translation and Training Lead
CRE RESPOND
Emeritus Professor
UQ Centre for Clinical Research

Associate Professor Sandra Peake

Dissemination Strategy Co-Lead
CRE RESPOND
ICU Physician and Chair of ANSICS-CTG Committee

Professor Gavin Joynt

Health Practitioner and Undergraduate Training Lead
CRE RESPOND
Critical Care Physician
Prince of Wales Hospital, Hong Kong

Professor Rinaldo Bellomo

Dissemination Strategy Co-Lead
CRE RESPOND
NHMRC Practitioner Fellow and ICU Physician, Co-Director
ANZICS Research Centre

Professor Jean-Yves Lefrant

European Collaboration Co-Lead
CRE RESPOND
ICU Physician and Chair of AZUREA Research
University of Nîmes

Associate Professor Cornelia Landersdorfer

Research Lead for Scientists
CRE RESPOND
NHMRC Career Development Fellow
Monash University