{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:28:10Z","timestamp":1783297690798,"version":"3.54.6"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Acute kidney injury (AKI) is a common complication of sepsis, contributing to an increased mortality rate. However, some studies have demonstrated that renal function improves in sepsis patients with AKI within 48\u2005hours, raising questions about the necessity for early antibiotic adjustment. This study evaluates the association between the timing of antipseudomonal \u03b2-lactam dose adjustment and the outcomes of critically ill sepsis patients with AKI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective, multicenter observational study of critically ill patients aged \u226518 years admitted to the intensive care unit with sepsis and AKI and started on antipseudomonal \u03b2-lactam therapy. After the initial dose, eligible patients were grouped as early \u03b2-lactam antibiotic (E-BLA) or late \u03b2-lactam antibiotic (L-BLA) dose adjustments based on the administration of subsequent renally adjusted doses within 24\u2005hours and after 24\u2005hours of sepsis recognition, respectively. The main outcome of interest was in-hospital mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1185 patients screened, 224 (mean age, 62.7 \u00b1 16.8 years; 62% were male) met inclusion criteria. Eighty-four and 140 patients were included in the E-BLA and L-BLA groups, respectively. Approximately half of the cohort presented with AKI stage II, and piperacillin-tazobactam was prescribed as initial empirical therapy in more than 50% of the cohort. In the multivariable Cox proportional hazards model, L-BLA was associated with a significant reduction in in-hospital mortality compared to E-BLA (hazard ratio, 0.588 [95% confidence interval, .355\u2013.974]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In sepsis patients with AKI, L-BLA was associated with in-hospital mortality benefits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae059","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T23:41:40Z","timestamp":1706830900000},"source":"Crossref","is-referenced-by-count":15,"title":["Early Versus Late Antipseudomonal \u03b2-Lactam Antibiotic Dose Adjustment in Critically Ill Sepsis Patients With Acute Kidney Injury: A Prospective Observational Cohort Study"],"prefix":"10.1093","volume":"11","author":[{"given":"Namareq F","family":"Aldardeer","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services, King Faisal Specialist Hospital and Research Centre , Jeddah , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maram M","family":"Alshreef","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Prince Sultan Military Medical City , Riyadh , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad A","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, King Fahad Hospital , Madinah , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad K","family":"Aljabri","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, King Fahad Hospital , Madinah , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad H","family":"Aljawadi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University , Riyadh , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thamer A","family":"Almangour","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University , Riyadh , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Alobaili","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nephrology Unit, King Saud University , Riyadh , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed I","family":"Alarifi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, College of Medicine, King Saud University , Riyadh , Saudi 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