Dose IndividualizAtion of Beta-lactam AntiBiotics in ICU patients: to TDM or not to TDM and the effects on patient outcome

Project summary

Beta-lactam antibiotics are commonly under-dosed in a large portion of ICU patients. Optimal dosing requires adjustment, but because of the variety of causes and changes in drug disposition it is not possible to predict exactly how in the individual patient. Therapeutic drug monitoring (TDM) of antimicrobials, determination of drug serum levels with the application of pharmacokinetic/pharmacodynamic (PK/PD) principles to optimize dosage regimens in individual patients, may optimize antibiotic treatment.
This multicenter, prospective, randomised trial will compare active TDM versus standard dosing of beta-lactams. The primary objective of this study is to show that the length of stay at the ICU decreases significantly in the group with active TDM (intervention group) in comparison to the group with no TDM (control group). Length of IC stay is associated with less mortality and less post-IC syndrome. In addition the study aims to show that active TDM results in improved clinical outcome, cost-effectiveness and quality of life.

Therapeutic drug monitoring (TDM) of antimicrobials in ICU patients may optimize antibiotic treatment, leading to a decrease in length of stay on the ICU and improved clinical outcome, cost-effectiveness and quality of life.