Abstract Pathophysiological changes are important risk factors for critically ill patients with pneumonia manifesting sub-therapeutic antibiotic exposures during empirical treatment. The effect of coronavirus disease 2019 (COVID-19) on antibiotic dosing requirements is uncertain. We aimed to determine the effect of COVID-19 on ß-lactam pharmacokinetics (PK) and PK target attainment in critically ill patients with a personalized dosing strategy. Retrospective, single-center analysis of COVID-19 ± critically ill patients with pneumonia (community-acquired pneumonia or hospital-acquired pneumonia) who received continuous infusion of a ß-lactam antibiotic with dosing personalized through dosing software and therapeutic drug monitoring. A therapeutic exposure was defined as serum concentration between (c ss ) 4 to 8 times the EUCAST non-species related breakpoint). Data from 58 patients with pneumonia was analyzed. Nineteen patients were tested COVID-19-positive before the start of the antibiotic therapy for community-acquired pneumonia or hospital-acquired pneumonia. Therapeutic exposure was achieved in 71% of COVID-19 patients (68% considering all patients). All patients demonstrated c ss above the non–species-related breakpoint. Twenty percent exceeded c ss above the target range (24% of all patients). The median ß-lactam clearance was 49% compared to ß-lactam clearance in a standard patient without a significant difference regarding antibiotic, time of sampling or present COVID-19 infection. Median daily doses were 50% lower compared to standard bolus dosing. COVID-19 did not significantly affect ß-lactam pharmacokinetics in critically ill patients. Personalized ß-lactam dosing strategies were safe in critically ill patients and lead to high PK target attainment with less resources.
【저자키워드】 Critical illness, Coronavirus disease 2019, Therapeutic Drug Monitoring, continuous infusion, PK/PD, ß-lactams, 【초록키워드】 COVID-19, Treatment, coronavirus disease, Pneumonia, risk factor, serum, COVID-19 infection, therapeutic, Patient, change, patients, critically ill patients, community-acquired pneumonia, antibiotic, Concentration, Analysis, COVID-19 patient, Safe, Critically ill patient, Antibiotic therapy, significant difference, single-center, daily dose, clearance, resources, Affect, breakpoint, defined, tested, analyzed, significantly, median, less, determine, demonstrated, exceeded, patients with pneumonia, therapeutic drug, 【제목키워드】 COVID-19, coronavirus disease, Pneumonia, Patient, Retrospective analysis, pharmacokinetic,