{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:21:14Z","timestamp":1790205674232,"version":"4.1.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T00:00:00Z","timestamp":1570665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Department of Anaesthesiology and Intensive Care Medicine"},{"name":"University Hospital of Nancy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Critically ill patients with severe intra-abdominal infections (IAIs) requiring surgery may undergo several pharmacokinetic (PK) alterations that can lead to \u03b2-lactam underdosage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To measure serum and peritoneal exudate concentrations of \u03b2-lactams after high doses and optimal administration schemes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This observational prospective study included critically ill patients with suspicion of IAI who required surgery and a \u03b2-lactam antibiotic as empirical therapy. Serum and peritoneal exudate concentrations were measured during surgery and after a 24\u2009h steady-state period. The PK\/pharmacodynamic (PD) target was to obtain serum \u03b2-lactam concentrations of 100% fT&amp;gt;4\u00d7MIC based on a worst-case scenario (based on the EUCAST highest epidemiological cut-off values) before bacterial documentation (a priori) and redefined following determination of the MIC for the isolated bacteria (a posteriori). Registered with ClinicalTrials.gov (NCT03310606).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-eight patients were included with a median (IQR) age of 64 (53\u201374) years and a SAPS II of 40 (32\u201365). The main diagnosis was secondary nosocomial peritonitis. Piperacillin\/tazobactam was the most administered \u03b2-lactam antibiotic (75%). The serum\/peritoneal piperacillin\/tazobactam ratio was 0.88 (0.64\u20130.97) after a 24\u2009h steady-state period. Prior to bacterial documentation, 16 patients (33.3%) achieved the a priori PK\/PD target. The identification of microorganisms was available for 34 patients (71%). Based on the MIC for isolated bacteria, 78% of the patients achieved the serum PK\/PD target.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In severe IAIs, high doses of \u03b2-lactams ensured 100% fT&amp;gt;4\u00d7MIC in the serum for 78% of critically ill patients with severe IAIs within the first 24\u2009h. In order to define optimal \u03b2-lactam dosing, the PK\/PD target should take into account the tissue penetration and local ecology.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz407","type":"journal-article","created":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T19:26:39Z","timestamp":1567625199000},"page":"156-161","source":"Crossref","is-referenced-by-count":20,"title":["Serum and peritoneal exudate concentrations after high doses of \u03b2-lactams in critically ill patients with severe intra-abdominal infections: an observational prospective study"],"prefix":"10.1093","volume":"75","author":[{"given":"Lisa","family":"Leon","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vand\u0153uvre-L\u00e8s-Nancy, F-54511, France"},{"name":"University of Lorraine, F-54000, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Guerci","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vand\u0153uvre-L\u00e8s-Nancy, F-54511, France"},{"name":"University of Lorraine, F-54000, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Pape","sequence":"additional","affiliation":[{"name":"University of Lorraine, F-54000, Nancy, France"},{"name":"Department of Clinical Pharmacology and Toxicology, University Hospital of Nancy, Nancy, F-5400, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Thilly","sequence":"additional","affiliation":[{"name":"University of Lorraine, F-54000, Nancy, France"},{"name":"Plateforme d\u2019aide \u00e0 la recherche Clinique, University Hospital of Nancy, Vand\u0153uvre-L\u00e8s-Nancy, F-54511, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandine","family":"Luc","sequence":"additional","affiliation":[{"name":"University of Lorraine, F-54000, Nancy, France"},{"name":"Plateforme d\u2019aide \u00e0 la recherche Clinique, University Hospital of Nancy, Vand\u0153uvre-L\u00e8s-Nancy, F-54511, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeline","family":"Germain","sequence":"additional","affiliation":[{"name":"University of Lorraine, F-54000, Nancy, France"},{"name":"Department of Surgery, University Hospital of Nancy, Vand\u0153uvre-L\u00e8s-Nancy, F-54511, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Lise","family":"Butin-Druoton","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vand\u0153uvre-L\u00e8s-Nancy, F-54511, France"},{"name":"University of Lorraine, F-54000, Nancy, 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