The association of antibiotic pharmacodynamic indices with survival in human septic shock
Septic shock and sepsis associated multiple organ failure are a major cause of morbidity and mortality in intensive care units (ICUs) globally. The treatment of patients with septic shock remains one of the major challenges to ICU clinicians. In this research, 342 bacteremic patients with septic shock were determined to have been treated with a β-lactam monotherapy. Objective: To show that key pharmacokinetic indices for a wide variety of β–lactams are associated with outcome in human septic shock. Methods: β-lactam pharmacodynamic (PD) indices including time above MIC and four times above MIC (ƒT>MIC, ƒT>4X MIC). Logistic regression analysis of 1st 24 hour time above MIC (p=.0005) and 1st 24 hour time above 4X MIC (p=.0003) were strongly associated with the improved survival of septic shock. Neither the 1st 24 hour Cpeak/MIC (p=.0762) or 1st 24 hour AUC/MIC (p=.0872) achieved significance in relation to outcome in logistic regression analysis.