Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial

AA Udy; JM Dulhunty; JA Roberts; JS Davis; SAR Webb; R Bellomo; C Gomersall; C Shirwadkar; GM Eastwood; J Myburgh; DL Paterson; T Starr; SK Paul; J Lipman; L Peck; H Young; C Boschert; J Fletcher; J Smith; K Nand; T Sara; A Harney; H Rodgers; F Van Haren; S Clarke; D Durham; C Hannan; E Matheson; K Schwartz; K Thomas; A Bone; C Cattigan; T Elderkin; T Salerno; R Cameron; K Ellis; S Hatter; M Sanap; N Soar; J Wood; K Chan; A Heffernan; NA Lai; C Moss; K Sheehy; M Duroux; M Ratcliffe; S Shone; T Warhurst; R Dunlop; J Stuart; D Cooper; R McAllister; A Cheng; D Inskip; J Miller; S Knowles; C Reynolds; S Rudham; S Baker; K Hepburn; B Roberts; P Woods; I Chatterjee; J Smith; M Cullen; J Kong; V Nayyar; C Whitehead; P Leung; E Gilder; L McCarthy; S McGuiness; R Parke; K Benefield; Y Chen; C McArthur; L Newby; S Henderson; J Mehrtens; S Noble; L Chadwick; R Freebain; C Hogan; A Kazemi; L Rust; R Song; A Tilsley; A Williams; J Durning; R Frengley; M La Pine; G McCracken; SB Sharma; L Andrews; R Dinsdale; A Hunt; S Hurford; D Mackle; J Ongley

Journal article

Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial

AA Udy, JM Dulhunty, JA Roberts, JS Davis, SAR Webb, R Bellomo, C Gomersall, C Shirwadkar, GM Eastwood, J Myburgh, DL Paterson, T Starr, SK Paul, J Lipman, L Peck, H Young, C Boschert, J Fletcher, J Smith, K Nand Show all

International Journal of Antimicrobial Agents | ELSEVIER SCIENCE BV | Published : 2017

DOI: 10.1016/j.ijantimicag.2016.12.022

Abstract

Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded. Primary outcome was alive ICU-free days at Day 28. Secondary outcomes included 90-day mortality and clinical cure at 14 days following antibiotic cessatio..

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University of Melbourne Researchers

Jason Roberts Author

Glenn Eastwood Author

Grants

Awarded by National Health and Medical Research Council

Funding Acknowledgements

This work was supported by the National Health and Medical Research Council, Australia; Health Research Council, New Zealand; Baxter Healthcare Pty Ltd.; and the Royal Brisbane and Women's Hospital/RBWH Foundation. JAR and JSD received salary funding from the National Health and Medical Research Council of Australia: Career Development Fellowship [APP1048652 to JAR] and Early Career Fellowship [APP1013411 to JSD]. SKP gratefully acknowledges infrastructure research support from the Australian Government's National Collaborative Research Infrastructure Strategy initiative through Therapeutic Innovation Australia.