Is a randomized trial of a short course of aminoglycoside added to β-lactam antibiotics for empirical treatment in critically ill patients with sepsis justified?
DSY Ong, CH van Werkhoven… - Clinical …, 2018 - clinicalmicrobiologyandinfection …
Aminoglycosides are among the most widely used antibiotics in intensive care units (ICU),
despite demonstrated absence of survival benefits when added to b-lactam therapy and
higher rates of adverse effects, such as nephrotoxicity, in patients with sepsis [1]. Yet most
studies evaluated prolonged courses of aminoglycosides, used multiple daily dosing
schedules or compared broad-spectrum b-lactam monotherapy to a combination of an
aminoglycoside with a less broad-spectrum b-lactam. As short courses (ie< 3 days) of once …
despite demonstrated absence of survival benefits when added to b-lactam therapy and
higher rates of adverse effects, such as nephrotoxicity, in patients with sepsis [1]. Yet most
studies evaluated prolonged courses of aminoglycosides, used multiple daily dosing
schedules or compared broad-spectrum b-lactam monotherapy to a combination of an
aminoglycoside with a less broad-spectrum b-lactam. As short courses (ie< 3 days) of once …
Re:'Is a randomized trial of a short course of aminoglycoside added to β-lactam antibiotics for empirical treatment in critically ill patients with sepsis justified?' …
A Heffernan, J Lipman… - Clinical …, 2018 - clinicalmicrobiologyandinfection …
We read with interest the comments from Ong et al.[1] regarding the need for a well-
designed randomized controlled trial (RCT) to provide evidence to guide clinicians
regarding the use of combined b-lactam antibiotic and aminoglycoside therapy for the
management of critically ill patients with sepsis or septic shock. We would like to highlight
the importance of appropriate dosing strategies and the inclusion of pharmacokinetic/
pharmacodynamic (PK/PD) sub-studies to provide further evidence about the potential utility …
designed randomized controlled trial (RCT) to provide evidence to guide clinicians
regarding the use of combined b-lactam antibiotic and aminoglycoside therapy for the
management of critically ill patients with sepsis or septic shock. We would like to highlight
the importance of appropriate dosing strategies and the inclusion of pharmacokinetic/
pharmacodynamic (PK/PD) sub-studies to provide further evidence about the potential utility …
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