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Updated: Jul 15, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Time over minimum inhibitory concentration and variations in beta-lactam concentrations during prolonged and

Ylva Mattisson1,2, Jonas Tverring1,2

  • 1Division of Infection Medicine, Department of Clinical Sciences, Lund University, Sweden.

The Journal of International Medical Research
|July 14, 2026
PubMed

Insights

Critically ill patients with septic shock achieved high antibiotic target attainment. All patients reached concentrations above the minimum inhibitory concentration (MIC), with 83% exceeding four times the MIC.

Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Antibiotic pharmacokinetics are highly variable in critically ill patients with septic shock.
  • Optimizing antibiotic dosing is crucial for effective treatment of severe infections.

Purpose of the Study:

  • To investigate antibiotic concentrations and time over minimum inhibitory concentration (MIC) in septic shock patients.
  • To compare prolonged versus intermittent infusion strategies for cefotaxime, piperacillin-tazobactam, and meropenem.

Main Methods:

  • Post hoc analysis of a prospective study involving 21 septic shock patients.
  • Plasma antibiotic concentrations analyzed over 72 hours post-ICU admission.
  • Target attainment calculated using MIC and epidemiological cut-off values.

Main Results:

  • All patients achieved 100% time over MIC for cefotaxime, piperacillin-tazobactam, and meropenem.
  • 83% of patients achieved 100% time over 4x MIC.
  • Continuous renal replacement therapy was associated with exceeding upper therapeutic antibiotic targets (OR 15).

Conclusions:

  • High target attainment for beta-lactam antibiotics was observed in critically ill septic shock patients.
  • Prolonged infusions appear effective in achieving therapeutic antibiotic levels.
  • Further research on RRT impact on antibiotic levels is warranted.
Keywords:
Septic shockbeta-lactam antibioticscontinuous renal replacement therapytarget attainmenttherapeutic drug monitoring

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