1. Clin Biochem. 2010 Apr;43(6):589-98. Epub 2009 Dec 28.

Empirical models for dosage optimization of four beta-lactams in critically ill
septic patients based on therapeutic drug monitoring of amikacin.

Delattre IK, Musuamba FT, Verbeeck RK, Dugernier T, Spapen H, Laterre PF,
Wittebole X, Cumps J, Taccone FS, Vincent JL, Jacobs F, Wallemacq PE.

Unit of Clinical Biochemistry, Université Catholique de Louvain, Avenue
Hippocrate, 10, B-1200 Brussels, Belgium.

OBJECTIVES: The study aims to develop empirical models able to predict the
pharmacokinetics (PK) of four beta-lactams using the amikacin (AMK) therapeutic
drug monitoring (TDM), in order to optimize their dosage regimens. DESIGN AND
METHODS: 69 critically ill septic patients were included. All received a first
dose of AMK combined with piperacillin/tazobactam, ceftazidime, cefepime or
meropenem. A multivariate analysis was performed to predict the beta-lactam PK
using AMK PK parameters estimated from TDM and using pathophysiological
variables. RESULTS: An optimal prediction model was identified for each PK
parameter of each beta-lactam. The best predictor of each model was one of the
AMK PK parameters estimated from TDM. Other variables included colloid solution, 
renal and hepatic biomarkers, age and body weight. CONCLUSION: PK of the four
beta-lactams could be easily and rapidly predicted in critically ill septic
patients using the AMK TDM. These predictions could improve the beta-lactam
dosages in clinical practice. Copyright 2009 The Canadian Society of Clinical
Chemists. Published by Elsevier Inc. All rights reserved.

PMID: 20036226 [PubMed - in process]