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- Menino Osbert Cotta, Belinda Gowen, Natasha Truloff, Evan Bursle, Brett McWhinney, Jacobus P J Ungerer, Jason A Roberts, and Jeffrey Lipman.
- From the Burns Trauma and Critical Care Research Centre, University of Queensland , Queensland , Australia.
- Infect Dis (Lond). 2015 Jan 1; 47 (10): 739-42.
AbstractA 35-year-old patient in intensive care with severe burn injury developed episodes of sepsis. Blood culture yielded a multidrug-resistant Pseudomonas aeruginosa and treatment was commenced with amikacin (minimum inhibitory concentration (MIC) 2-4 mg/L, dose 20 mg/kg adjusted body weight 24-hourly) and meropenem (MIC 8 mg/L, dose 2 g IV 8-hourly and later 6-hourly). Despite the use of extended infusions with β-lactam therapeutic drug monitoring and doses that were more than 2.5 times higher than standard meropenem doses, resistance emerged. This case report describes the application of therapeutic drug monitoring to optimize β-lactam therapy in a difficult-to-treat critically ill patient.
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