The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting

The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting

Background: This study aims to determine if continuous infusion (CI) of beta-lactam antibiotics achieves the pharmacokinetic/pharmacodynamic (PK/PD) targets for time-dependent bacterial killing and/or are associated with improved clinical outcomes compared to intermittent bolus (IB) dosing in critic...

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Main Authors: Abdul Aziz, Mohd. Hafiz, Sulaiman, Helmi, Mat Nor, Mohd. Basri, Rai, Vineya, Wong, K., Hasan , Mohd Shahnaz, Wallis, Steven C, Lipman, Jeffrey, Staatz, Christine E., Roberts, Jason A.
Format: Conference or Workshop Item
Language:English
English
Published: 2015
Subjects:
RM300 Drugs and their action
RS Pharmacy and materia medica
Online Access:http://irep.iium.edu.my/44991/
http://irep.iium.edu.my/44991/
http://irep.iium.edu.my/44991/1/BLISS_ICAACv4.pdf
http://irep.iium.edu.my/44991/6/44991.pdf
id iium-44991
recordtype eprints
spelling iium-449912015-11-30T07:27:39Z http://irep.iium.edu.my/44991/ The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting Abdul Aziz, Mohd. Hafiz Sulaiman, Helmi Mat Nor, Mohd. Basri Rai, Vineya Wong, K. Hasan , Mohd Shahnaz Wallis, Steven C Lipman, Jeffrey Staatz, Christine E. Roberts, Jason A. RM300 Drugs and their action RS Pharmacy and materia medica Background: This study aims to determine if continuous infusion (CI) of beta-lactam antibiotics achieves the pharmacokinetic/pharmacodynamic (PK/PD) targets for time-dependent bacterial killing and/or are associated with improved clinical outcomes compared to intermittent bolus (IB) dosing in critically ill patients with severe sepsis. Methods: This is a report from the BLISS Study which was a prospective, multicentre, open-labelled, randomised, controlled trial of CI vs IB dosing of beta-lactam antibiotics, recruiting critically ill patients with severe sepsis from two Malaysian ICUs. The primary end-point, PK/PD target attainment, was evaluated at the halfway point and end of the dosing interval on days 1 and 3 of treatment, by comparing beta-lactam concentrations against causative pathogens based on EUCAST MIC. Secondary end-points were number of days before patient’s white blood cell (WBC) count normalised and that patient’s required infection-related mechanical ventilation (MV), as well as 14-day mortality. Results: 140 critically ill patients with severe sepsis were enrolled with 70 patients each randomly allocated to the CI and IB treatment arms. APACHE II (CI 22 vs IB 20, p = 0.336) and SOFA (CI 9 vs IB 8, p = 0.217) scores were similar between CI and IB patients. CI patients demonstrated numerically higher PK/PD target attainment rates compared to IB patients at the halfway point (CI 96.6% vs IB 83.9%, p = 0.022) and end (CI 96.6% vs IB 62.5%, p < 0.001) of the dosing interval on Day 1, and at the halfway point (CI 100.0% vs IB 85.7%, p = 0.003) and end (CI 98.2% vs IB 58.9%, p < 0.001) of the dosing interval on Day 3, respectively. WBC count normalisation (CI 4 vs IB 6 days, p = 0.014) and infection-related MV (CI 6 vs IB 9 days, p = 0.038) were shorter for CI patients. Mortality rates (CI 17.7% vs IB 16.0%, p = 0.807) were similar between CI and IB patients. Conclusion: Preliminary results of the BLISS study provide additional PK/PD and clinical outcome data to support the practice of CI administration of beta-lactam antibiotics in critically ill patients with severe sepsis. 2015 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/44991/1/BLISS_ICAACv4.pdf application/pdf en http://irep.iium.edu.my/44991/6/44991.pdf Abdul Aziz, Mohd. Hafiz and Sulaiman, Helmi and Mat Nor, Mohd. Basri and Rai, Vineya and Wong, K. and Hasan , Mohd Shahnaz and Wallis, Steven C and Lipman, Jeffrey and Staatz, Christine E. and Roberts, Jason A. (2015) The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting. In: Joint 55th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and 28th International Congress of Chemotherapy (ICC) Meeting (ICAAC/ICC 2015), 17-21 September 2015, San Diego, CA. (Unpublished) http://www.abstractsonline.com/Plan/ViewSession.aspx?sKey=eeeaba1b-2666-42d0-be09-8f7f806718f9
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
English
topic RM300 Drugs and their action
RS Pharmacy and materia medica
spellingShingle RM300 Drugs and their action
RS Pharmacy and materia medica
Abdul Aziz, Mohd. Hafiz
Sulaiman, Helmi
Mat Nor, Mohd. Basri
Rai, Vineya
Wong, K.
Hasan , Mohd Shahnaz
Wallis, Steven C
Lipman, Jeffrey
Staatz, Christine E.
Roberts, Jason A.
The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting
description Background: This study aims to determine if continuous infusion (CI) of beta-lactam antibiotics achieves the pharmacokinetic/pharmacodynamic (PK/PD) targets for time-dependent bacterial killing and/or are associated with improved clinical outcomes compared to intermittent bolus (IB) dosing in critically ill patients with severe sepsis. Methods: This is a report from the BLISS Study which was a prospective, multicentre, open-labelled, randomised, controlled trial of CI vs IB dosing of beta-lactam antibiotics, recruiting critically ill patients with severe sepsis from two Malaysian ICUs. The primary end-point, PK/PD target attainment, was evaluated at the halfway point and end of the dosing interval on days 1 and 3 of treatment, by comparing beta-lactam concentrations against causative pathogens based on EUCAST MIC. Secondary end-points were number of days before patient’s white blood cell (WBC) count normalised and that patient’s required infection-related mechanical ventilation (MV), as well as 14-day mortality. Results: 140 critically ill patients with severe sepsis were enrolled with 70 patients each randomly allocated to the CI and IB treatment arms. APACHE II (CI 22 vs IB 20, p = 0.336) and SOFA (CI 9 vs IB 8, p = 0.217) scores were similar between CI and IB patients. CI patients demonstrated numerically higher PK/PD target attainment rates compared to IB patients at the halfway point (CI 96.6% vs IB 83.9%, p = 0.022) and end (CI 96.6% vs IB 62.5%, p < 0.001) of the dosing interval on Day 1, and at the halfway point (CI 100.0% vs IB 85.7%, p = 0.003) and end (CI 98.2% vs IB 58.9%, p < 0.001) of the dosing interval on Day 3, respectively. WBC count normalisation (CI 4 vs IB 6 days, p = 0.014) and infection-related MV (CI 6 vs IB 9 days, p = 0.038) were shorter for CI patients. Mortality rates (CI 17.7% vs IB 16.0%, p = 0.807) were similar between CI and IB patients. Conclusion: Preliminary results of the BLISS study provide additional PK/PD and clinical outcome data to support the practice of CI administration of beta-lactam antibiotics in critically ill patients with severe sepsis.
format Conference or Workshop Item
author Abdul Aziz, Mohd. Hafiz
Sulaiman, Helmi
Mat Nor, Mohd. Basri
Rai, Vineya
Wong, K.
Hasan , Mohd Shahnaz
Wallis, Steven C
Lipman, Jeffrey
Staatz, Christine E.
Roberts, Jason A.
author_facet Abdul Aziz, Mohd. Hafiz
Sulaiman, Helmi
Mat Nor, Mohd. Basri
Rai, Vineya
Wong, K.
Hasan , Mohd Shahnaz
Wallis, Steven C
Lipman, Jeffrey
Staatz, Christine E.
Roberts, Jason A.
author_sort Abdul Aziz, Mohd. Hafiz
title The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting
title_short The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting
title_full The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting
title_fullStr The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting
title_full_unstemmed The BLISS study: Beta-Lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a Malaysian ICU setting
title_sort bliss study: beta-lactam infusion in severe sepsis-randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis in a malaysian icu setting
publishDate 2015
url http://irep.iium.edu.my/44991/
http://irep.iium.edu.my/44991/
http://irep.iium.edu.my/44991/1/BLISS_ICAACv4.pdf
http://irep.iium.edu.my/44991/6/44991.pdf
first_indexed 2023-09-18T21:03:59Z
last_indexed 2023-09-18T21:03:59Z
_version_ 1777410810083016704

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