Scientific Poster Session IV - Students Research-in-Progress

Abstract

There is currently not an extensive repository of studies that support definitive dosing strategies of beta-lactam antibiotics in critically-ill obese patients due to the complexity of obesity-related and critically ill-related alterations in pharmacokinetics. Many of the available studies evaluating beta-lactam antibiotics, such as piperacillin-tazobactam, cefepime, and meropenem, in this population are pharmacokinetic-based studies while few studies evaluate clinical endpoints, such as clinical cure rate.

Research Question or Hypothesis:

Are patients with obesity at greater risk of clinical failure when treated with beta-lactam antibiotics?

Study Design:

Retrospective Cohort with three study arms -- BMI =40 kg/m², BMI 30-39 kg/m², and BMI of <30 kg/m²

Methods:

A retrospective chart review of Princeton Baptist Medical Center's electronic health record from July 31, 2021, and July 31, 2024, was performed. The inclusion criteria include age of at least 18 years, admitted to the ICU, confirmed diagnosis of Pseudomonas aeruginosa or Enterbacterales bloodstream infection via blood culture, and received definitive (effective) antibiotic treatment involving piperacillin-tazobactam, cefepime, and/or meropenem. The exclusion criteria include active cancer, pregnancy, and concomitant gram-positive infections. Baseline characteristics to be gathered are sex; race; height/weight; past medical history; beta lactam allergy; general labs including serum creatinine and white blood cell count; microbiological data; infection source; baseline symptoms; baseline rating scales including SOFA score and Charlson Comorbidity Score; and vitals including maximum body temperature. The primary outcome is clinical cure rate defined by a composite of the following: normalization of white blood cell count and temperature; lack of escalation or transition to aminoglycosides, polymyxin/colistin, or aztreonam; off vasopressors; negative blood culture; symptom relief; transition to oral antibiotics; or transition to the general medical floor. The secondary outcomes are microbiological cure defined by negative blood culture, death from any cause, duration of therapy, and individual antibiotic regimen association with clinical cure and clinical failure.

Results:

In Progress

Conclusion:

In Progress

Presenting Author

Authors