International Survey of Antibiotic Dosing and Monitoring in Adult Intensive Care Units

23 Jun 2023

A University of Queensland study has identified an increase in more accurate antibiotic dosing by hospitals globally, raising the chances of successful treatments for critically ill patients. 

Researchers surveyed 538 study participants (71 percent physicians and 29 percent pharmacists) from 409 hospitals in 45 countries to determine the dosing, administration and monitoring of antibiotics.

They compared the results with the previous international antibiotic dosing survey conducted in 2015.

PhD candidate Paul Williams, from UQ’s Centre for Clinical Research, said the findings show more accurate doses of commonly used antibiotics for patients in intensive care units (ICU).

“The number of piperacillin/tazobactam extended and continuous infusions doubled and the use of meropenem extended infusions increased by 23 percent,” Mr Williams said.

“There has also been a 23 percent increase in beta-lactam therapeutic drug monitoring.

“High-income countries were more likely to administer more accurate doses of vancomycin and perform drug concentration monitoring of aminoglycoside drugs.

“And beta-lactam prolonged infusions were now predominantly administered as extended infusions (3-4 hour infusions).” 

Therapeutic drug monitoring has been rising in clinical practice globally, particularly in academic hospitals.

Mr Williams said this was needed to ensure optimal antibiotic exposure and increasing treatment success in patients with serious infections.

“Determining the appropriate dose of antibiotics for ICU patients is challenging because extreme levels of sickness severity can lead to highly varied drug concentrations, which directly impacts treatment success,” he said.

“It is concerning that 25 percent of those surveyed omitted giving personalised vancomycin doses, and that this was more prevalent in respondents from lower income countries.

“Our findings recommend that strategies be introduced to increase appropriate use of more accurate vancomycin dosing.”

This study is published in the journal SpringerNature. DOI:  10.1186/s13054-023-04527-1