{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T02:48:06Z","timestamp":1775789286059,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["R01AI158530"],"award-info":[{"award-number":["R01AI158530"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["R21AI174159"],"award-info":[{"award-number":["R21AI174159"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individualized dosing of beta-lactam using serum concentrations is an emerging approach to overcome PK\/PD variability in select patients. Herein, we describe a beta-lactam dose individualization programme highlighting successes and challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-centre evaluation of a beta-lactam dose individualization using serum concentration monitoring programme. In September 2023, a pharmacist-driven protocol was implemented at an academic centre as a collaboration between Infectious Diseases, Pharmacy, and the Clinical Laboratory. De-centralized pharmacists ordered serum concentrations for cefepime, meropenem or piperacillin-tazobactam treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Interpretation was conducted using Bayesian software. The drug monitored, treatment indication, model fitness, whether therapy was altered, whether protocols were followed and PK\/PD attainment for each patient were recorded. Eighty-two beta-lactam serum levels were ordered in 47 patients between 26 September 2023 and 31 March 2024. Cefepime was most frequently monitored (70.7%). Common treatment indications in monitored patients were hospital-acquired\/ventilator-associated pneumonia (25.5%), surgical prophylaxis (12.8%), bone\/joint (12.8%) and central nervous system infection (12.8%). Model fitness was good or intermediate in &amp;gt;95% of cases. Dose or agent optimization was possible in 60% of cases, and dose adjustments were made in 34% of cases. Protocol deviations were common (57.4%). Targets of 100% fT&amp;gt;1\u00d7MIC and fT&amp;gt;4\u00d7MIC were achieved in 91.5% and 61.7% of patients, respectively. Troughs exceeding protocol safety goals occurred &amp;gt;20% of the time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found that dose optimization was possible in &amp;gt;50% of monitored patients necessitating dose adjustments &amp;gt;33% of the time. Protocol deviations reinforced areas for continued pharmacist and provider education to optimize the use of this targeted intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlag047","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T12:46:16Z","timestamp":1774010776000},"source":"Crossref","is-referenced-by-count":0,"title":["Individualizing beta-lactam dosing in real-world patients: lessons from a pharmacist-led programme implementation and evaluation"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7512-1151","authenticated-orcid":false,"given":"Samantha","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Northwestern Memorial Hospital , Chicago, IL ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Weslander","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Northwestern Memorial 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