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Clinical Study on Monitoring the Plasma Concentration of Ceftazidime-Avibactam in Critically Ill Patients

Active, not recruiting
Conditions
Severe Sepsis
Registration Number
NCT05413343
Lead Sponsor
First Affiliated Hospital of Zhejiang University
Brief Summary

A observational study is conducting at the First Affiliated Hospital of the Medical College of Zhejiang University from June 1, 2021 to January 1, 2024. Patients with severe sepsis and treatment with Ceftazidime-avibactam (CAZ-AVI) will be enrolled.

Blood samples at different time points: 0 hour, 2 hours, 4 hours, 6 hours, and 8 hours after the first time and the steady state concentration(more than 4 times drug administration) of drug administration will be collected to detect plasma drug concentrations of CAZ-AVI.

Detailed Description

The investigators will collect the blood samples at different time points: 0 hour, 2 hours, 4 hours, 6 hours, and 8 hours after the first time and the steady state concentration(more than 4 times drug administration) of drug administration from the patients receive treatment with CAZ-AVI to detect plasma drug concentrations of CAZ-AVI. The collected specimens will be stored in a refrigerator at 0-8 °C, centrifuges within 24 hours (4 °C, 4000 r/min, 10 min), and the supernatant will be collected in an EP tube and stored at -80°C until subsequent analysis. Ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS/MS) will be used to detect plasma drug concentrations of CAZ-AVI. According to the outcomes ,the investigators will characterize the population pharmacokinetics (PPK) of CAZ-AVI in critically ill patients and performed pharmacodynamic target attainment analyses to determine optimal dosing regimens for patients with and without continuous renal replacement therapy (CRRT).

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Patients with severe sepsis and treated with ceftazidime avibactam
  • Age ≥ 18 years
  • The patient or authorized persons agree and sign the informed consent
  • The patient's hemoglobin is greater than 70g/l during blood collection
Exclusion Criteria
  • The expected length of ICU stay less than 48 hours,
  • Pregnant woman,
  • The blood sample is hemolysis.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Plasma drug concentrations of CAZ-AVI0 hour, 2 hours, 4 hours, 6 hours, and 8 hours after the steady state concentration (more than 4 times drug administration) of drug administration

Plasma drug concentrations of CAZ-AVI after the steady state concentration (more than 4 times drug administration) of drug administration

A population pharmacokinetic (PopPK) model for CAZ-AVI and to propose an appropriate dosing regimen in Chinese critically ill patients.After obtaining the patient's plasma drug concentration

By conducting pharmacokinetic and pharmacodynamic analysis on the plasma drug concentration data of patients receiving CAZ-AVI treatment in the intensive care unit, we aim to develop a population pharmacokinetic (PopPK) model for critically ill patients in China and to formulate an appropriate dosing regimen for critically ill patients with varying degrees of renal function, including those undergoing renal replacement therapy.

Secondary Outcome Measures
NameTimeMethod
Serum albuminThe day of the steady state concentration (more than 4 times drug administration) of drug administration

The level of serum albumin on the day of the steady state concentration(more than 4 times drug administration) of drug administration

The level of creatinineThe day of the first time of the steady state concentration (more than 4 times drug administration) of drug administration

The level of creatinine on the day of the steady state concentration(more than 4 times drug administration) of drug administration

The level of glomerular filtration rateThe day of the steady state concentration (more than 4 times drug administration) of drug administration

The level of glomerular filtration rate on the day of the steady state concentration (more than 4 times drug administration) of drug administration

Whether received renal replacement therapyThe day of the steady state concentration (more than 4 times drug administration) of drug administration

Whether the patient received renal replacement therapy on the day of the steady state concentration (more than 4 times drug administration) of drug administration, and the results are recorded in the form of categorical variables,(e.g.,yes or no).

Respiratory functionThe day of the steady state concentration (more than 4 times drug administration) of drug administration

Whether the patient received mechanical ventilation on the day of the steady state concentration (more than 4 times drug administration) of drug administration, and the results are recorded in the form of categorical variables,(e.g.,yes or no).

Cardiovascular functionThe day of the steady state concentration (more than 4 times drug administration) of drug administration

Whether the patient received vasoactive agents(including norepinephrine, epinephrine, dobutamine, and metarylamine), and the results are recorded in the form of categorical variables,(e.g.,yes or no).

CRRT treatment dosageThe day of the steady state concentration (more than 4 times drug administration) of drug administration

The specific parameters for patients undergoing CRRT include the type of CRRT machine, treatment modality, treatment method, filter type, treatment duration, pre-dilution volume, post-dilution volume, blood pump flow rate, dialysis pump flow rate, average hourly fluid removal, treatment dose, ultrafiltration rate, and waste fluid volume

microbiological clearance, infection-related mortality14 day after the onset of infection

microbiological clearance, 14 day infection-related mortality,

all-cause mortality30 day and 90 day after the onset of infection

30 day all-cause mortality,90 day all-cause mortality

length of stayFrom ICU admission to ICU discharge will be measured(assessed up to 120 days).

Total ICU length of stay.

Trial Locations

Locations (1)

The First Affiliated Hospital,College of Medicine,Zhejiang University

🇨🇳

Hangzhou, Zhejiang, China

The First Affiliated Hospital,College of Medicine,Zhejiang University
🇨🇳Hangzhou, Zhejiang, China

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