Impact of imipenem and amikacin pharmacokinetic/pharmacodynamic parameters on microbiological outcome of Gram-negative bacilli ventilator-associated pneumonia

摘要: OBJECTIVES Despite recent advances, antibiotic therapy of ventilator-associated pneumonia (VAP) in ICU patients is still challenging. We assessed the impact imipenem and amikacin pharmacokinetic pharmacodynamic parameters on microbiological outcome these patients. PATIENTS AND METHODS Patients with Gram-negative bacilli (GNB) VAP were prospectively included. Blood samples for analysis collected after empirical administration a combination three times daily one single dose amikacin. MICs estimated each GNB obtained from respiratory samples. Microbiological success was defined as ≥10(3) cfu/mL decrease bacterial count quantitative cultures between baseline third day treatment. RESULTS Thirty-nine [median (min-max) age = 60 years (28-84) median SAPS2 at inclusion = 40 (19-73)] Median 0.25 mg/L (0.094-16) 2 (1-32), respectively. over MIC 5× 100% (8-100) 74% (3-100), The C1/MIC ratio 23 (1-76); 34 (87%) achieved ≥10. occurred 29 (74%). No parameter significantly associated success. For amikacin, higher group: 26 (1-76) versus 11 (3-26) (P = 0.004). CONCLUSIONS In VAP, classic targets are easily reached usual dosing regimens. this context, than previously described might be necessary.