Administration and therapeutic drug monitoring of ß-lactams 2 and vancomycin in critical care units in Colombia : The ANTI- 3 BIOCOL study

Abstract

Therapeutic Drug Monitoring (TDM) and continuous infusion strategies are effec- 15 tive interventions in clinical practice, but these practices are little still unknown in Colombia, 16 especially in the critical care setting. This study aims to describe the practices of administra- 17 tion and TDM of time-dependent antibiotics reported by specialists in critical care in Colom- 18 bia and to explore the factors that are related to the use of extended infusion. An online na- 19 tionwide survey was applied to 153 specialists selected randomly. A descriptive, bivariate 20 analysis and a logistic regression model were performed. Of the 88.9% of intensivists referred 21 to TDM availability, 21.57% has access to results access in less than 6 hours. TDM was avail- 22 able mainly for vancomycin. 85.62% of the intensivists had some type of institutional proto- 23 col, however, only 39.22% had a complete and socialized protocol. The odds of preferring 24 extended infusions among those who do not have institutional protocols decrease by 80% 25 compared with those with complete protocols, OR 0.2 (95% CI: 0.06 - 0.61). The most im- 26 portant perceived barriers to performing continuous infusions and TDM are the lack of train- 27 ing and technologies. This pioneering study in Colombia could impact the quality of care and 28 outcomes of critically ill patients on the threat that is antimicrobial resistance.