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The primary aim of the study is to determine the proportion of individuals receiving beta-lactam antibiotics at Imperial College Healthcare NHS Trust in whom drug concentration targets are achieved.
To address the challenge of antimicrobial resistance (AMR) it is imperative that the current finite pool of antimicrobial agents is optimised, to maximise therapeutic success, limit the risk of drug toxicity, whilst minimising emergence of resistance.
Outside of the critical care setting it is not known how many patients are receiving optimal drug concentrations for the treatment of infection.
This study aims to assess whether antimicrobial targets are being achieved in these individuals and explore how clinical co-variates and outcomes may relate to this. Furthermore, it aims to identify priority groups and/or drugs where there are gaps in dose optimisation research and develop hypotheses which can be tested in observational studies.
Eligible participants will be enrolled and observed during their management of infection at Imperial College NHS Trust. After providing informed consent their clinical data will be collected from electronic healthcare records and they will provide samples that will undergo drug concentration analysis.
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| Measure | Description | Time Frame |
|---|---|---|
| Determine the number of individuals receiving beta-lactam antibiotics at Imperial College Healthcare NHS Trust in whom drug concentration targets are achieved. | Determine the number of individuals receiving beta-lactam antibiotics at Imperial College Healthcare NHS Trust in whom drug concentration targets are achieved | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Find the number of individuals receiving co-administered non-beta-lactam antibiotics in whom drug concentration targets are achieved. | Find the number of individuals receiving co-administered non-beta-lactam antibiotics in whom drug concentration targets are achieved. | 3 years |
| Show how clinical co-variates, co-administered medications and treatment outcomes relate to target attainment, and identify groups of patients in who therapeutic drug monitoring may be beneficial. |
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Inclusion Criteria:
18 years of age or above.
Exclusion Criteria:
Less than 18 years of age
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As per inclusion criteria
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Suzy Williams | Contact | +44 (0) 20 3313 2732 | suzanne.williams@imperial.ac.uk | |
| Richard Wilson, MPharm | Contact | richard.wilson@imperial.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Alison Holmes, MD | Imperial College London | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Imperial College Healthcare NHS Trust | Recruiting | London | W12 0HS | United Kingdom |
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| ID | Term |
|---|---|
| D001424 | Bacterial Infections |
| D064420 | Drug-Related Side Effects and Adverse Reactions |
| ID | Term |
|---|---|
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D064419 | Chemically-Induced Disorders |
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Sera, saliva, urine, nasal mucous, CSF, renal replacement fluid, CSF
Show how clinical co-variates, co-administered medications and treatment outcomes relate to target attainment, and identify groups of patients in who therapeutic drug monitoring may be beneficial. |
| 3 years |
| Illustrate dynamic patterns of infection-related biomarkers which may indicate the presence/absence of treatment response. | Illustrate dynamic patterns of infection-related biomarkers which may indicate the presence/absence of treatment response. | 3 years |
| Show how drug-levels obtained through minimally invasive sampling and the use of residual specimens relate to blood, and how these could be used to inform individual dose-optimisation. | Show how drug-levels obtained through minimally invasive sampling and the use of residual specimens relate to blood, and how these could be used to inform individual dose-optimisation. | 3 years |
| Build a repository of real life PK-PD data which can be used to generate hypotheses and guide the development of interventional dose optimisation studies | Build a repository of real life PK-PD data which can be used to generate hypotheses and guide the development of interventional dose optimisation studies | 3 years |