Critically ill patients often have varying physiological needs to an average patient and often require different dosages of antibiotics and other drugs, particularly if they are on renal replacement therapies. There is also a controversy over whether bolus dosing or continuous infusion of β-lactams is more effective in antibiotic delivery in critically ill patients. Professor Lipman has pioneered work that demonstrates that patients in intensive care are not receiving enough antibiotics to achieve optimal levels to kill pathogens. This in turn leads to poorer health outcomes for patients and antibiotic resistance. Antibiotic resistant infections commonly occur in long stay, debilitated patients and contribute to increased risk of death, longer ICU and hospital stay, further weakness and long term dysfunction. This problem also contributes to patients being unable to be discharged from ICU or hospital and so exacerbating the shortage of acute hospital beds and increases in surgery waiting time.

Current projects

  • Creatinine clearance of critically ill Australian indigenous patients – a longitudinal study (CROC Study). Tsai D, Udy A, Stewart P, Gourley S, Morick N, Lipman J, Roberts J. Funder: NHMRC Postgraduate Scholarship
  • Non-Haemolytic Friulimicins for the Treatment of Multi-Drug Resistant Bacteria. Cooper M, Roberts J, Butler M. Funder: NHMRC
  • Pharmacokinetics of Enteric Coated Mycophenolate Sodium in Lupus Nephritis (POEMSLUN). Ranganathan D, Roberts J, John G, Fassett R, Healy H, Lipman J, Kubler P, Ungerer J. Funder: RBWH
  • Epidemiology of Pneumonia in the Central Australian Intensive Care Unit. Tsai D, Goud R, Hewagama S, Stewart P, Hnin K-M, Tin K-S, Sun H, Roberts J. Funder: NHMRC Postgraduate Scholarship (D Tsai); Australian Academy of Science (D Tsai).
  • Pharmacokinetics of broad spectrum antibiotics in extracorporeal membrane oxygenation (ECMO) - using plasma concentrations to optimize antibiotic therapy. Welch S, Roberts J, Burrows F, Levkovich B, Ray J, Pellegrino V, Bui T, Wallis S, Marriott D, Rudham S. Funder: Society of Hospital Pharmacists of Australia (SHPA), RBWH Foundation
  • Antibiotic, sedative and analgesic drug pharmacokinetics during ovine extracorporeal membrane oxygenation - understanding altered pharmacokinetics to improve patient outcomes. Shekar K, Roberts J, Smith M, Fung Y, Fraser J, Wallis S, Mullany D, Diab S, McDonald C, Barnet A, Ghassabian S, Platts D, Dunster K. Funder: ANZCA, TPCH Foundation, ANZICS
  • The Pharmacokinetics of Vancomycin and Ticarcillin-Clavulanate in Critically Ill Patients undergoing Sustained Low-Efficiency Dialysis (SLED). Economu C. Funder RBWH Scholarship
  • Ketorolac pharmacokinetics in joint replacements. Roberts J, Wallis S, Gurunathan U.
  • Sampling Antibiotics in Renal Replacement Therapy (SMARRT Study).  Roberts J,  Lipman J, Roberts M, Paul S, Peake S, Turnidge J, Joynt G, Lee A, Gomersall C, Choi G. Funder: NHMRC; Chinese University of Hong Kong
  • Does inhaled antibiotics deliver optimal concentrations to the lung to improve treatment of pneumonia. An animal in vivo study using the microdialysis technique. Dhanani J, Paterson D, Roberts J, Chew M, Fraser J. Funder: RBWH
  • Dosing to maximise bacterial killing and prevent resistance in ICU. Roberts J, Lipman J, Wallis S,  Kirkpatrick C, Landersdorfer C, Bulitta J, Bergen P. Funder: NHMRC
  • Piperacillin and cefazolin pharmacokinetics in sepsis and trauma. Roberts J, Lipman J, Udy A, Wallis S, Kirkpatrick C, Kruger P, Roberts M.
  • PARITY: Paracetamol in Traumatic Brain Injury. Principal Investigator: Gowardman J, Roberts J, Lipman J, Wallis S, Saxena M.
  • Continuous vs bolus cefazolin in abdominal surgery patients (collaboration with University of Virginia). Roberts J, Lipman J, Wallis S, Naik B, Ikeda K, Todorovic M.
  • Antibiotic pharmacokinetic study in renal replacement therapy - CVVHF vs CVVHDF (collaboration with CHU Nimes). Roberts J, Lipman J, Wallis S, Lefrant J-Y, Roger C, Muller L. Funder: Le Centre Hospitalier Universitaire de Nimes (CHU Nimes)
  • Antibiotic pharmacokinetics in Slow Low Efficiency Dialysis (piperacillin, meropenem and vancomycin; collaboration with The Ottawa Hospital). Roberts J, Kanji S, Zelenitsky S.
  • Teiciplanin pharmacokinetics and protein binding in methicillin resistant S. aureus infection (collaboration with Trinity College Ireland). Roberts J, D'Arcy D, Byrne C.
  • CAMERA: Combination antibiotic treatment for Methicillin Resistant Staphylococcus Aureus Bacteraemia – an RCT. Davis J, Tong S, Paterson D, Fowler V, Howden B, Cheng A, Chatfield M, Lipman J, van Hal S, O’Sullivan M. Funder: NHMRC
  • Validation of Microsampling Versus Traditional Blood Sampling For Antibiotic Pharmacokinetics. Chikatamarla A, Parker S, Wallis S, Lipman J, Presneill J, Roberts J, Dorofaeff T, Jarrett P. Funder: RBWH Foundation; AHEPA
  • Pharmacokinetics of Antibiotics in the critically unwell children. Dorofaeff T. Funder: AHEPA
  • Population pharmacokinetics of meropenem in critically ill patients and development of dosing software (Collaboration with University of Liverpool). Roberts J, Hope W, Belen A.
  • Meropenem and ciprofloxacin pharmacokinetics in ICU patients with shock (MaC-DIPPS). Roberts J, Lipman J, Sjovall F, Christrup L, Kreilgaard M, Perner A, Frimodt-Møller N.
  • Plasma and tissue pharmacokinetics of lincomycin in patients with burn wound infection. Muller M, Wang L, Roberts J, Lipman J. Funder: RBWH Foundation
  • An Investigation of the Pharmacokinetics of Pip/taz, Meropenem and Fluconazole in Critically Ill Obese Patients (PHANCO). Alobaid A, Roberts J, Lipman J, Roberts M. Funder: Saudi Arabian Cultural Mission
  • Incidence, Risk Factors, Consequences and Treatment of Ventilated Patients with Nosocomial Infection with Pandrug Resistant Organisms in Hospitals in Asia. McGloughlin S, Webb S, Lipman J, Paterson D, Roberts J, Phau J. Funder: ICF; University of Western Australia – UQ Collaboration
  • Pharmacokinetic Australasian Collaborative. Lipman J, Roberts J, Joynt G, Udy A, Nicholas M. Funder: ICF
  • Optimising benzylpenicillin dosing for critically ill patients with severe pneumonia. Roberts J, Cotta O, Boots R. Funder: RBWH Foundation
  • A Phases III Randomized Controlled Trial of Continuous β-lactam Infusion Compared with Intermittent β-lactam Dosing in Critically ill patients. Dulhunty J, Starr T, Lipman J. Funder: RBWH Foundation
  • Levetiracetam pharmacokinetics in critically ill patients with severe traumatic brain injury and subarachnoid hemorrhage. Cotta O, Roberts J, Presneill J. Funder: ICF, RBWH Foundation
  • Optimising ceftriaxone dosing for critically ill patients with severe pneumonia. Roberts J, Cotta O, Boots R. Funder: RBWH Foundation
  • Improving piperacillin/tazobactam dosing in critically ill Australian Indigenous patients with severe sepsis. Tsai D, Stewart P, Goud R, Gourley S, Hewagama S, Krishnaswamy S, Wallis S, Lipman J, Roberts J. Funder: NHMRC Postgraduate Scholarship (D Tsai); Australian Academy of Science (D Tsai)
  • Improving meropenem dosing in critically ill Australian Indigenous patients with severe sepsis. Tsai D, Stewart P, Goud R, Gourley S, Hewagama S, Krishnaswamy S, Wallis S, Lipman J, Roberts J. Funder: NHMRC Postgraduate Scholarship (D Tsai); Australian Academy of Science (D Tsai)
  • Improving vancomycin dosing in critically ill Australian Indigenous patients with severe sepsis. Tsai D, Stewart P, Goud R, Gourley S, Hewagama S, Krishnaswamy S, Wallis S, Lipman J, Roberts J. Funder: NHMRC Postgraduate Scholarship (D Tsai); Australian Academy of Science (D Tsai)
  • Improving ceftriaxone dosing in critically ill Australian Indigenous patients with severe sepsis.
  • Tsai D, Stewart P, Goud R, Gourley S, Hewagama S, Krishnaswamy S, Wallis S, Lipman J, Roberts J. Funder: NHMRC Postgraduate Scholarship (D Tsai); Australian Academy of Science (D Tsai)
  • Residual antibiotics post reconstitution: REPORT Study. Jarrett P, Coyer F, Cook J, Wallis S, Cotta O, Cohen J. 

Clinical trials

ASAP-ECMO (Extracorporeal Membrane Oxygenation): A multi-centre Australian pharmacokinetic study evaluating the pharmacokinetics of various antibiotics, antifungals, sedatives and analgesics in critically ill patients receiving extracorporeal membrane oxygenation. Principal Site Investigator: J Roberts

BLING III: A phase III randomised controlled trial of continuous beta-lactam infusion compared with intermittent beta-lactam dosing in critically ill patients. Principal Site Investigator: J Lipman

Ceftolozane/Tazobactam RRT: An observational pharmacokinetic study of Ceftolozane-Tazobactam in Intensive Care Unit in patients with and without continuous renal replacement therapy. Principal Site Investigator: J Roberts

Ceftolozane/Tazobactam EVD: A prospective observational pharmacokinetic evaluation of the plasma and cerebrospinal fluid concentrations of a single dose ceftolozane/tazobactam in infected critically ill patients with an indwelling external ventricular drain. Principal Site Investigators: J Roberts, J Lipman

Colonic Flora: Assessing the effects of antibiotic choice on gut microbiota of ICU patients - a metagenomic approach. Principal Site Investigators: D Paterson, P Harris, S Schlebusch

Microsampling: Validation of microsampling versus traditional blood sampling for antibiotic pharmacokinetics. Principal Site Investigators: J Lipman, S Wallis

OASES: The Pharmacokinetics of Ceftriaxone, Meropenem, Piperacillin-Tazobactam and Vancomycin in the Cerebrospinal Fluid of Critically Ill Patients with Uninflamed Meninges. Principal Site Investigators: J Roberts, N Kumta

RESIST: Recognising Sepsis in SIRS Trial. Principal Site Investigator: K Denny

Research support

  • Tertiary Intensive Care Unit - all pathology and radiological investigations available
  • Tertiary Burns Unit - all pathology and radiological investigations available
  • Skin Culture Facility
  • Fully equipped bioanalytical laboratory with HPLC & LCMS capabilities
  • Hollow fibre infection model -  a state- of- the art dynamic in vitro infection model for pharmacokinetic/pharmacodynamic profiling of antibiotics 
  • Screening antibacterial activity with static-concentration time-kill kinetics and susceptibility assays

Resources

  • Epidemiological support
  • Statistical advice
  • Expert postgraduate supervision
  • Data mining