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A survey of beta-lactam antibiotics and vancomycin dosing strategies in intensive care units and general wards in Belgian hospitals.

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Abstract
Extended and continuous infusions with beta-lactam antibiotics have been suggested as a means of pharmacokinetic and pharmacodynamic optimisation of antimicrobial therapy. Vancomycin is also frequently administered in continuous infusion, although more for practical reasons. A survey was undertaken to investigate the recommendations by the local antibiotic management teams (AMTs) in Belgian acute hospitals concerning the administration (intermittent, extended or continuous infusion) and therapeutic drug monitoring of four beta-lactam antibiotics (ceftazidime, cefepime, piperacillin-tazobactam, meropenem) and vancomycin for adult patients with a normal kidney function. A structured questionnaire survey comprising three domains was developed and approved by the members of the Belgian Antibiotic Policy Coordination Committee (BAPCOC). The questionnaire was sent by e-mail to the official AMT correspondents of 105 Belgian hospitals, followed by two reminders. The response rate was 32 %, with 94 %, 59 %, 100 %, 100 % and 100 % of the participating Belgian hospitals using ceftazidime, cefepime, piperacillin-tazobactam, meropenem and vancomycin, respectively. Comparing intensive care unit (ICU) with non-ICU wards showed a higher implementation of extended or continuous infusions for ceftazidime (81 % vs. 41 %), cefepime (35 % vs. 10 %), piperacillin-tazobactam (38 % vs. 12 %), meropenem (68 % vs. 35 %) and vancomycin (79 % vs. 44 %) on the ICU wards. A majority of the hospitals recommended a loading dose prior to the first dose. For vancomycin, the loading dose and the trough target concentration were too low based on the current literature. This survey shows that extended and continuous infusions with beta-lactams and vancomycin are widely implemented in Belgian hospitals.
Keywords
INTERMITTENT INFUSION, CONTINUOUS-INFUSION, CYSTIC-FIBROSIS, STABILITY, PHARMACODYNAMICS, INFECTIONS, MEROPENEM

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MLA
Buyle, Franky, Johan Decruyenaere, Jan De Waele, et al. “A Survey of Beta-lactam Antibiotics and Vancomycin Dosing Strategies in Intensive Care Units and General Wards in Belgian Hospitals.” EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES 32.6 (2013): 763–768. Print.
APA
Buyle, F., Decruyenaere, J., De Waele, J., Tulkens, P. M., Van Audenrode, T., Depuydt, P., Claeys, G., et al. (2013). A survey of beta-lactam antibiotics and vancomycin dosing strategies in intensive care units and general wards in Belgian hospitals. EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 32(6), 763–768.
Chicago author-date
Buyle, Franky, Johan Decruyenaere, Jan De Waele, Paul M Tulkens, Thijs Van Audenrode, Pieter Depuydt, Geert Claeys, Hugo Robays, and Dirk Vogelaers. 2013. “A Survey of Beta-lactam Antibiotics and Vancomycin Dosing Strategies in Intensive Care Units and General Wards in Belgian Hospitals.” European Journal of Clinical Microbiology & Infectious Diseases 32 (6): 763–768.
Chicago author-date (all authors)
Buyle, Franky, Johan Decruyenaere, Jan De Waele, Paul M Tulkens, Thijs Van Audenrode, Pieter Depuydt, Geert Claeys, Hugo Robays, and Dirk Vogelaers. 2013. “A Survey of Beta-lactam Antibiotics and Vancomycin Dosing Strategies in Intensive Care Units and General Wards in Belgian Hospitals.” European Journal of Clinical Microbiology & Infectious Diseases 32 (6): 763–768.
Vancouver
1.
Buyle F, Decruyenaere J, De Waele J, Tulkens PM, Van Audenrode T, Depuydt P, et al. A survey of beta-lactam antibiotics and vancomycin dosing strategies in intensive care units and general wards in Belgian hospitals. EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES. 2013;32(6):763–8.
IEEE
[1]
F. Buyle et al., “A survey of beta-lactam antibiotics and vancomycin dosing strategies in intensive care units and general wards in Belgian hospitals.,” EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, vol. 32, no. 6, pp. 763–768, 2013.
@article{3229358,
  abstract     = {Extended and continuous infusions with beta-lactam antibiotics have been suggested as a means of pharmacokinetic and pharmacodynamic optimisation of antimicrobial therapy. Vancomycin is also frequently administered in continuous infusion, although more for practical reasons. A survey was undertaken to investigate the recommendations by the local antibiotic management teams (AMTs) in Belgian acute hospitals concerning the administration (intermittent, extended or continuous infusion) and therapeutic drug monitoring of four beta-lactam antibiotics (ceftazidime, cefepime, piperacillin-tazobactam, meropenem) and vancomycin for adult patients with a normal kidney function. A structured questionnaire survey comprising three domains was developed and approved by the members of the Belgian Antibiotic Policy Coordination Committee (BAPCOC). The questionnaire was sent by e-mail to the official AMT correspondents of 105 Belgian hospitals, followed by two reminders. The response rate was 32 %, with 94 %, 59 %, 100 %, 100 % and 100 % of the participating Belgian hospitals using ceftazidime, cefepime, piperacillin-tazobactam, meropenem and vancomycin, respectively. Comparing intensive care unit (ICU) with non-ICU wards showed a higher implementation of extended or continuous infusions for ceftazidime (81 % vs. 41 %), cefepime (35 % vs. 10 %), piperacillin-tazobactam (38 % vs. 12 %), meropenem (68 % vs. 35 %) and vancomycin (79 % vs. 44 %) on the ICU wards. A majority of the hospitals recommended a loading dose prior to the first dose. For vancomycin, the loading dose and the trough target concentration were too low based on the current literature. This survey shows that extended and continuous infusions with beta-lactams and vancomycin are widely implemented in Belgian hospitals.},
  author       = {Buyle, Franky and Decruyenaere, Johan and De Waele, Jan and Tulkens, Paul M and Van Audenrode, Thijs and Depuydt, Pieter and Claeys, Geert and Robays, Hugo and Vogelaers, Dirk},
  issn         = {0934-9723},
  journal      = {EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES},
  keywords     = {INTERMITTENT INFUSION,CONTINUOUS-INFUSION,CYSTIC-FIBROSIS,STABILITY,PHARMACODYNAMICS,INFECTIONS,MEROPENEM},
  language     = {eng},
  number       = {6},
  pages        = {763--768},
  title        = {A survey of beta-lactam antibiotics and vancomycin dosing strategies in intensive care units and general wards in Belgian hospitals.},
  url          = {http://dx.doi.org/10.1007/s10096-012-1803-7},
  volume       = {32},
  year         = {2013},
}

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