Effect of therapeutic drug monitoring-based dose optimisation of piperacillin/tazobactam in sepsis patients

Growing evidence suggests that insufficient antibiotic exposure (defined as failure to achieve the pharmacokinetic/pharmacodynamic (PK/PD) target to kill or inhibit the growth of a pathogen) is associated with worse clinical outcomes in sepsis patients.

Moreover, up to 50% of critically ill patients receiving a β-lactam antibiotic with regimens based on manufacturers' recommendations fail to reach the target.

Therapeutic drug monitoring (TDM)-guided therapy has been proposed as a strategy to further optimise the achievement of the PK/PD target of β-lactam antibiotics. However, there are no data on whether piperacillin/tazobactam TDM can improve clinical outcomes.

In this context, a large RCT was performed to investigate whether TDM-based dose optimisation versus fixed dosing could improve clinical outcomes in patients with sepsis treated with piperacillin/tazobactam as a continuous infusion.

Dr Hagel shares with us the results of this study published in the ICM Journal.

Original study:

Hagel S et al. Effect of therapeutic drug monitoring-based dose optimization of piperacillin/tazobactam on sepsis-related organ dysfunction in patients with sepsis: a randomized controlled trial. Intensive Care Med. 2022 Mar;48(3):311-321. doi: 10.1007/s00134-021-06609-6

Speakers

Stefan HAGEL. Assistant medical director and consultant at the Institute for Infectious Diseases and Infection Control and Center for Sepsis Control and Care at the Jena University Hospital (DE).

Laura BORGSTEDT. Department of Anesthesiology, Klinikum rechts der Isar, Technical University of Munich, Munich (DE).