{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:37:36Z","timestamp":1770813456428,"version":"3.50.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["RC-2024-2790678"],"award-info":[{"award-number":["RC-2024-2790678"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the biliary pharmacokinetic\/pharmacodynamic (PK\/PD) of continuous infusion (CI) ceftazidime\u2013avibactam in a series of critical orthotopic liver transplant (OLT) recipients having pre-emptive therapy during OLT because of carbapenemase-producing Enterobacterales (CPE) rectal colonization or targeted therapy of CPE intra-abdominal (IAIs) and\/or biliary tract infections (BTIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed an exploratory, hypothesis-generating prospective case series including critical OLT recipients carrying a Kehr\u2019s tube and undergoing therapeutic drug monitoring of ceftazidime and avibactam in both bile and plasma simultaneously while receiving CI ceftazidime\u2013avibactam pre-emptive or targeted therapy. Biliary aggressive joint PK\/PD target attainment [defined as a free ceftazidime steady-state concentrations fCss\/MIC ratio &amp;gt;4 coupled with an avibactam fCss\/target concentration (CT\u200a=\u200a4\u2005mg\/L) ratio &amp;gt;1] was selected as optimal threshold of ceftazidime\u2013avibactam efficacy, given this was previously shown to be independently associated with lower rates of microbiological failure and resistance development. Bile-to-plasma fCss ratios were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, four critical OLT recipients were included. Aggressive biliary ceftazidime\u2013avibactam joint PK\/PD target during treatment with CI 2\u2005g\/0.5\u2005g q8\u2005h over 8\u2005h was attained in 2\/4 cases (quasi-optimal and suboptimal in one case each). Median (range) fCss bile-to-plasma ratios were 0.28 (0.22\u20130.38) for ceftazidime and 0.24 (0.11\u20130.52) for avibactam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our limited cases series suggested that both ceftazidime and avibactam showed a moderate and broadly similar biliary penetration. Administration by CI may be helpful in attaining an aggressive biliary joint PK\/PD target of ceftazidime\u2013avibactam against pathogens with an MIC up to 8\u2005mg\/L.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag009","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:42:54Z","timestamp":1767876174000},"source":"Crossref","is-referenced-by-count":0,"title":["Biliary pharmacokinetic\/pharmacodynamic analysis of continuous infusion ceftazidime\u2013avibactam in a case series of orthotopic liver transplant recipients"],"prefix":"10.1093","volume":"81","author":[{"given":"Milo","family":"Gatti","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]},{"name":"Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna 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Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]},{"name":"Operative Unit of Microbiology, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Siniscalchi","sequence":"additional","affiliation":[{"name":"Division of Anesthesiology, Department of Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierluigi","family":"Viale","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]},{"name":"Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna 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