Dose optimization by PK/PD of antibiotics to improve clinical outcome of CRKP bloodstream infections in critically ill patients and in vitro study of monotherapy, combination therapy and molecular biology of drug resistance at Phramongkutklao Hospital: Prospective, historical controlled study

Faculty of Pharmacy, Silpakorn University0 个研究点目标入组 76 人开始时间: 2023年4月11日最近更新: 2024年8月19日

适应症

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•1. 20 years and older who admitted at Phramongkutklao Hospital
•2. Patients who was diagnosed blood stream infection with CRKP between April 10th, 2023 to March 31st, 2024 (Prospective study) and January 1st, 2012 to March 31st, 2023 (Retrospective study); Historical group
•3. Patients who had signs and symptoms at least 1 criteria following:
•3.1. Patients who had signs and symptoms of Systemic Inflammatory Response Syndrome (SIRS) at least 2 criteria:
•- Temperature above 38 oC or below 36 oC
•- Heart rate more than 90 beats/min
•- Respiratory rate more than 20 /min or PaCO2 less than 32 mmHg (4.3 kPa)
•- White blood cell more than 12,000 cell/mm3 or less than 4,000 cell/mm3
•3.2. Patients who was diagnosed sepsis or SOFA score or qSOFA score at least 2 score
•3.3. Patients who was diagnosed septic shock or who had hypotension with adequate fluid and need for vasopressor to maintain mean arterial pressure over 65 mmHg and serum lactate above 2 mmol/L
•4. Patients who received antibiotics at least 48 hours which are as follow:
•- Ceftazidime-Avibactam or
•- Combination antibiotics (eg. Meropenem-Colistin, Imipenem-Colistin, Tigecycline-Amikacin, Tigecycline-Gentamicin, Tigecycline-Meropenem or Tigecycline-Colistin)

•1. Patients who were pregnancy or breastfeeding
•2. Patients who had drug allergy (eg. Ceftazidime-Avibactam, Tigecycline, Amikacin, Gentamicin, Imipenem, Meropenem or Colistin)
•3. Patients who not to received resuscitation.
•4. Patients who were end stage cancer.

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