{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T04:02:10Z","timestamp":1771214530893,"version":"3.50.1"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Innovation and Clinical Research of Ghent University Hospital, Belgium","award":["FIKO22\/TYPE2\/017"],"award-info":[{"award-number":["FIKO22\/TYPE2\/017"]}]}],"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>Age-related pathophysiological changes may impact the pharmacokinetics and pharmacodynamics (PK\/PD) of \u00df-lactam antibiotics, potentially resulting in suboptimal concentrations in older adults. This study evaluated PK\/PD target attainment with current intravenous amoxicillin-clavulanate and piperacillin-tazobactam dosing regimens in older adults, identified risk factors for target non-attainment, and assessed the prevalence of toxic concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective, observational PK study in geriatric inpatients (\u226575\u2005years) who were treated intravenously with amoxicillin-clavulanate (1\u2005g\/0.2\u2005g q6h as a 30-minute infusion) or piperacillin-tazobactam (4\u2005g\/0.5\u2005g q6h as a 3-hour infusion). Trough blood samples were collected in steady-state conditions. Target attainment was evaluated against a 100%fT\u200a&amp;gt;\u200aMIC target. Risk factors for target non-attainment were identified by multivariable logistic regression analysis. Toxicity thresholds were defined as total Cmin concentrations of 80\u2005mg\/L for amoxicillin and 157.2\u2005mg\/L for piperacillin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-four patients (median age (IQR): 87\u2005years (83\u201390)) were included. The PK\/PD target was achieved in 15 of 35 and 33 of 39 patients for amoxicillin-clavulanate and piperacillin-tazobactam, respectively. Multivariable logistic regression analysis revealed an effect of comorbidity burden, assessed by the Cumulative Illness Rating Scale-Geriatric (CIRS-G), and estimated glomerular filtration rate that explained 23.8% of target non-attainment (P\u200a&amp;lt;\u200a0.05). Receiver operator characteristic curves identified an eGFR of 67\u2005mL\/min\/1.73m2 as a threshold associated with an increased risk of target non-attainment. Toxicity thresholds were never exceeded in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Health status and renal function, rather than chronological age, play a significant role in target non-attainment among older adults. Further research is required to delineate predictors for interpatient variability in PK and develop evidence-based dosing strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Registration in ClinicalTrials.gov<\/jats:p>\n                    <jats:p>Trial registration number: NCT04436991<\/jats:p>\n                    <jats:p>Registration date: 16\/06\/2020<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag048","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T12:43:46Z","timestamp":1769777026000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for suboptimal target attainment of commonly used \u00df-lactam antibiotics in older adults: a prospective cohort 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