B-lactams serum concentrations in critically ill cirrhotic patients: a matched-control study

Methods We reviewed data from critically ill cirrhotic patients and matched controls in whom routine therapeutic drug monitoring (TDM) of broad-spectrum b-lactam antibiotics (ceftazidime or cefepime, CEF; piperacillin/tazobactam; TZP; meropenem, MEM) was performed. Serum drug concentrations were measured twice during the elimination phase by high-performance liquid chromatography (HPLC-UV). Antibiotic PKs were calculated using a one-compartment model. We considered therapy was adequate when serum drug concentrations were between 4 and 8 times the minimal inhibitory concentration (MIC) of Pseudomonas aeruginosa during optimal periods of time for each drug (≥70% for CEF; ≥ 50% for TZP; ≥ 40% for MEM).