{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:06:10Z","timestamp":1780502770691,"version":"3.54.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100031045","name":"Children\u2019s Health Queensland Study Education and Research Trust account","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031045","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001794","name":"The University of Queensland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001794","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian National Health and Medical Research Council for a Centre of Research Excellence"},{"DOI":"10.13039\/501100008483","name":"NOMIS foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008483","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Thomas and Doris Ammann Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Critically ill children receiving continuous renal replacement therapy may experience sub-therapeutic concentrations for antimicrobials leading to treatment failure and antimicrobial resistant pathogens. The objective of this study was to determine whether antimicrobial concentrations are reduced by a paediatric continuous renal replacement therapy (CRRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>An ex vivo closed continuous veno\u2013venous haemodiafiltration was simulated for a 3\u2005kg infant to assess antimicrobial clearance across three ultrafiltration rates (zero, low and high flux). Slow continuous ultrafiltration was used to assess antimicrobial adsorption and recovery over 240\u2005minutes. Controls were included to account for spontaneous drug degradation. This study was conducted in a university research laboratory with no participants. Antimicrobial concentrations were measured using a validated HPLC-MS\/MS method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The antimicrobial filter clearance during high-flux filtration was significantly increased for fluconazole, piperacillin, tazobactam, vancomycin and voriconazole (P\u200a&amp;lt;\u200a0.05). The antimicrobial recovery [mean (%)] at 240\u2005minutes in the CRRT model was significantly different from baseline (time zero) for ampicillin 49%, fluconazole 76%, gentamicin (0%) meropenem 51%, piperacillin 54%, vancomycin 31% and voriconazole 47% (P\u200a&amp;lt;\u200a0.05). A significant relationship was demonstrated between antimicrobial recovery and molecular charge (R2\u200a=\u200a0.58 P\u200a&amp;lt;\u200a0.001) in the CRRT model; no relationships were reported for lipophilicity or protein binding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The concentrations were reduced in &amp;gt;70% of the study antimicrobials in the ex vivo paediatric CRRT model, as a result of an increase in filter clearance during high-flux filtration or from drug-circuit adsorption. These findings suggests that antimicrobial dosing in critically ill children receiving CRRT requires assessment to determine whether antimicrobial concentrations are therapeutic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag189","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:40:06Z","timestamp":1779190806000},"source":"Crossref","is-referenced-by-count":0,"title":["The impact of an\n                    <i>ex vivo<\/i>\n                    paediatric renal replacement therapy circuit on antimicrobial concentrations"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8736-9737","authenticated-orcid":false,"given":"Michele L","family":"Cree","sequence":"first","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]},{"name":"Pharmacy Department, Queensland Children\u2019s Hospital , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8889-5579","authenticated-orcid":false,"given":"Mohd Hafiz","family":"Abdul-Aziz","sequence":"additional","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2392-9854","authenticated-orcid":false,"given":"Steven C","family":"Wallis","sequence":"additional","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayoung","family":"Won","sequence":"additional","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandra D","family":"Sumi","sequence":"additional","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusan","family":"Marjanovic","sequence":"additional","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny L","family":"Ordonez","sequence":"additional","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luregn J","family":"Schlapbach","sequence":"additional","affiliation":[{"name":"UQ, Centre for Children\u2019s Health Research , Brisbane ,","place":["Australia"]},{"name":"Department of Intensive Care and Neonatology, and Children`s Research Center, University Children's Hospital Zurich, University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A","family":"Roberts","sequence":"additional","affiliation":[{"name":"UQ Centre for Clinical Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland , Brisbane ,","place":["Australia"]},{"name":"Department of Intensive Care Medicine, Royal Brisbane & Women\u2019s Hospital , Brisbane ,","place":["Australia"]},{"name":"Herston Infectious Diseases Institute (HeIDI), Level 8, UQ Centre for Clinical Research Royal Brisbane and Women\u2019s Hospital , 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