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DALI : Defining Antibiotic Levels in Intensive care unit patients : a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic

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Abstract
Background: The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. Methods: DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. Discussion: The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.
Keywords
beta eta-lactam, Antibiotic, Glycopeptide, Triazole, Echinocandin, Continuous infusion, Extended infusion, Bolus dosing, Adverse events, Pharmacokinetics, Pharmacodynamics, RENAL REPLACEMENT THERAPY, ACUTE KIDNEY INJURY, SEPTIC PATIENTS, POPULATION PHARMACOKINETICS, ANTIMICROBIAL THERAPY, SEVERE SEPSIS, PHARMACODYNAMICS, SIMULATIONS, INFECTIONS, MEROPENEM

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MLA
Roberts, Jason A, Jan De Waele, George Dimopoulos, et al. “DALI : Defining Antibiotic Levels in Intensive Care Unit Patients : a Multi-centre Point of Prevalence Study to Determine Whether Contemporary Antibiotic Dosing for Critically Ill Patients Is Therapeutic.” BMC INFECTIOUS DISEASES 12 (2012): n. pag. Print.
APA
Roberts, Jason A, De Waele, J., Dimopoulos, G., Koulenti, D., Martin, C., Montravers, P., Rello, J., et al. (2012). DALI : Defining Antibiotic Levels in Intensive care unit patients : a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic. BMC INFECTIOUS DISEASES, 12.
Chicago author-date
Roberts, Jason A, Jan De Waele, George Dimopoulos, Despoina Koulenti, Claude Martin, Philippe Montravers, Jordi Rello, et al. 2012. “DALI : Defining Antibiotic Levels in Intensive Care Unit Patients : a Multi-centre Point of Prevalence Study to Determine Whether Contemporary Antibiotic Dosing for Critically Ill Patients Is Therapeutic.” Bmc Infectious Diseases 12.
Chicago author-date (all authors)
Roberts, Jason A, Jan De Waele, George Dimopoulos, Despoina Koulenti, Claude Martin, Philippe Montravers, Jordi Rello, Andrew Rhodes, Therese Starr, Steven C Wallis, and Jeffrey Lipman. 2012. “DALI : Defining Antibiotic Levels in Intensive Care Unit Patients : a Multi-centre Point of Prevalence Study to Determine Whether Contemporary Antibiotic Dosing for Critically Ill Patients Is Therapeutic.” Bmc Infectious Diseases 12.
Vancouver
1.
Roberts JA, De Waele J, Dimopoulos G, Koulenti D, Martin C, Montravers P, et al. DALI : Defining Antibiotic Levels in Intensive care unit patients : a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic. BMC INFECTIOUS DISEASES. 2012;12.
IEEE
[1]
J. A. Roberts et al., “DALI : Defining Antibiotic Levels in Intensive care unit patients : a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic,” BMC INFECTIOUS DISEASES, vol. 12, 2012.
@article{2978534,
  abstract     = {Background: The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. 
Methods: DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. 
Discussion: The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.},
  articleno    = {152},
  author       = {Roberts, Jason A and De Waele, Jan and Dimopoulos, George and Koulenti, Despoina and Martin, Claude and Montravers, Philippe and Rello, Jordi and Rhodes, Andrew and Starr, Therese and Wallis, Steven C and Lipman, Jeffrey},
  issn         = {1471-2334},
  journal      = {BMC INFECTIOUS DISEASES},
  keywords     = {beta eta-lactam,Antibiotic,Glycopeptide,Triazole,Echinocandin,Continuous infusion,Extended infusion,Bolus dosing,Adverse events,Pharmacokinetics,Pharmacodynamics,RENAL REPLACEMENT THERAPY,ACUTE KIDNEY INJURY,SEPTIC PATIENTS,POPULATION PHARMACOKINETICS,ANTIMICROBIAL THERAPY,SEVERE SEPSIS,PHARMACODYNAMICS,SIMULATIONS,INFECTIONS,MEROPENEM},
  language     = {eng},
  pages        = {7},
  title        = {DALI : Defining Antibiotic Levels in Intensive care unit patients : a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic},
  url          = {http://dx.doi.org/10.1186/1471-2334-12-152},
  volume       = {12},
  year         = {2012},
}

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