Antibiotic Dosing in Geriatric Patients At the Emergency Department
University Hospital, Ghent
180 participants
Jan 3, 2018
OBSERVATIONAL
Conditions
Summary
In this pilot study, we will investigate whether - with the current dosing regimens, used in the Ghent University Hospital - pharmacodynamic targets regarding beta-lactam antibiotics (more specific Amoxicilline-Clavulanate, Piperacillin-Tazobactam and Temocillin) are attained in frail patients admitted to the geriatric department.
Eligibility
Inclusion Criteria5
- Patients presenting at the emergency department and later on admitted to the geriatric department
- Patient age 75 years or older
- Patients with geriatric profile according to KATZ scale, G8 screening test or CIRS score.
- Patient receiving antibiotic treatment (amoxicillin-clavulanate, piperacillin-tazobactam)
- Intravenous access available for blood sampling. For measurement of the peak concentration an intravenous access other than the drug infusion line is required.
Exclusion Criteria4
- Admission to other units than the geriatric department incl. the ICU.
- Absence of informed consent
- Known hypersensitivity to beta-lactam antibiotics
- Patients who received oral amoxicillin-clavulanate prior to admission will not be included in the iv. amoxicillin-clavulanate group.
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Interventions
At predefined time points through a venous catheter already in place. Max. volume to be withdrawn: Maximum 4ml/sample. Maximum 10 samples/patient. A last blood sample will be taken, if necessary, after the end of antibiotic therapy, between day 7 and day 14. Though blood results preferably will be used from available data from tests already done during standard treatment. Samples are collected in lithium-heparin tubes (without gel) and centrifuged immediately (within a maximum of 30 minutes after sampling) at room temperature: 8 minutes at 1885g. Plasma is then collected and divided in two separated labelled Eppendorf tubes 1.5 ml and immediately frozen at - 80 °C. If this is not immediately possible, tubes are frozen at - 20 °C and at regular time points transferred to a freezer at - 80 °C (minimum twice a day).
Bacteriological specimen, such as blood cultures, urine samples, sputum ea., which are usually collected in every patient according to standard care will be retained. If there is bacterial growth, MIC's will be calculated on these strains for study purpose.
Bacteriological specimen, such as blood cultures, urine samples, sputum ea., which are usually collected in every patient according to standard care will be retained. If there is bacterial growth, MIC's will be calculated on these strains for study purpose.
Bacteriological specimen, such as blood cultures, urine samples, sputum ea., which are usually collected in every patient according to standard care will be retained. If there is bacterial growth, MIC's will be calculated on these strains for study purpose.
Locations(1)
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NCT04436991