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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2016

Open Access 01-12-2016 | Study protocol

SaMpling Antibiotics in Renal Replacement Therapy (SMARRT): an observational pharmacokinetic study in critically ill patients

Authors: Jason A. Roberts, Gordon Y. S. Choi, Gavin M. Joynt, Sanjoy K. Paul, Renae Deans, Sandra Peake, Louise Cole, Dianne Stephens, Rinaldo Bellomo, John Turnidge, Steven C. Wallis, Michael S. Roberts, Darren M. Roberts, Melissa Lassig-Smith, Therese Starr, Jeffrey Lipman

Published in: BMC Infectious Diseases | Issue 1/2016

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Abstract

Background

Optimal antibiotic dosing is key to maximising patient survival, and minimising the emergence of bacterial resistance. Evidence-based antibiotic dosing guidelines for critically ill patients receiving RRT are currently not available, as RRT techniques and settings vary greatly between ICUs and even individual patients. We aim to develop a robust, evidence-based antibiotic dosing guideline for critically ill patients receiving various forms of RRT. We further aim to observe whether therapeutic antibiotic concentrations are associated with reduced 28-day mortality.

Methods/Design

We designed a multi-national, observational pharmacokinetic study in critically ill patients requiring RRT. The study antibiotics will be vancomycin, linezolid, piperacillin/tazobactam and meropenem. Pharmacokinetic sampling of each patient’s blood, RRT effluent and urine will take place during two separate dosing intervals. In addition, a comprehensive data set, which includes the patients’ demographic and clinical parameters, as well as modality, technique and settings of RRT, will be collected. Pharmacokinetic data will be analysed using a population pharmacokinetic approach to identify covariates associated with changes in pharmacokinetic parameters in critically ill patients with AKI who are undergoing RRT for the five commonly prescribed antibiotics.

Discussion

Using the comprehensive data set collected, the pharmacokinetic profile of the five antibiotics will be constructed, including identification of RRT and other factors indicative of the need for altered antibiotic dosing requirements. This will enable us to develop a dosing guideline for each individual antibiotic that is likely to be relevant to any critically ill patient with acute kidney injury receiving any of the included forms of RRT.

Trial registration

Australian New Zealand Clinical Trial Registry (ACTRN12613000241​730) registered 28 February 2013
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Metadata
Title
SaMpling Antibiotics in Renal Replacement Therapy (SMARRT): an observational pharmacokinetic study in critically ill patients
Authors
Jason A. Roberts
Gordon Y. S. Choi
Gavin M. Joynt
Sanjoy K. Paul
Renae Deans
Sandra Peake
Louise Cole
Dianne Stephens
Rinaldo Bellomo
John Turnidge
Steven C. Wallis
Michael S. Roberts
Darren M. Roberts
Melissa Lassig-Smith
Therese Starr
Jeffrey Lipman
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-1421-6

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