%0 Journal Article
%A Lechtig Wasserman, Sharon
%A Liebisch Rey, Hans
%A Diaz Pinilla, Nicolas
%A Blanco, Jhosep
%A Fuentes Barreiro, Yuli-Viviana
%A Bustos, Rosa Helena
%8 2021-02-10
%@ 2079-6382
%U http://hdl.handle.net/10818/48222
%X Drug monitoring is one strategy of antibiotic stewardship to face antimicrobial resistance.
This strategy could have a determinant role in critically ill patients treated with carbapenems to
overcome pharmacokinetic variability, reduce the risk of subtherapeutic dosage or toxicity, and
reduce the risks inherent to treatment. However, the effectiveness of therapeutic drug monitoring
(TDM) is unknown. This paper aims to identify TDM effectiveness in critically ill patients treated
with carbapenems. English and ClinicalTrials.gov databases were searched to identify relevant
studies evaluating carbapenem TDM. Randomized controlled trials (RCTs) and comparative cohort
studies were selected for inclusion if they compared carbapenem TDM to standard care in adult
critically ill or sepsis/septic shock patients. The primary outcome was mortality. Secondary outcomes
included morbidity, clinical cure, microbiological eradication, antimicrobial resistance, drug-related
side effects, and achievement of target plasma concentrations. Overall, performing carbapenem TDM
was not associated with a decrease in mortality. However, it could be evidence for a relationship with
clinical cure as well as target attainment. Some studies found favorable outcomes related to clinical
and microbiological responses, such as lower procalcitonin levels at the end of the monitored therapy
compared to standard care. For the primary and secondary outcomes analyzed, strong evidence was
not identified, which could be due to the size, risk of bias, and design of selected studies.
%I Antibiotics
%T Carbapenem Therapeutic Drug Monitoring in Critically Ill Adult Patients and Clinical Outcomes: A Systematic Review with Meta-Analysis
%R 10.3390/antibiotics10020177
%~ Intellectum