- This project will commence in September 2017 and run for 15 months.
- Run by University Hospitals of Leicester NHS Trust.
- Being implemented at the adult and paediatric intensive care units at Glenfield Hospital, Leicester.
- Aims to improve the way in which antibiotics are used in intensive care patients with MRSA blood stream infections.
- Personalised dosing of the antibiotic vancomycin will be delivered to patients through the use of computer models that use demographic and routinely generated clinical data.
Bacterial sepsis is a major cause of morbidity and mortality in adult and paediatric intensive care unit (ICU) patients. Antibiotics are essential for treating sepsis. However, selecting the optimum dose to achieve target levels in the blood is difficult in ICU patients, as disease and physiological changes affect pharmacokinetics (PK) and pharmacodynamics (PD).
With the current dosing approach, critically ill patients are at risk of not achieving the PK/PD targets that will lead to positive clinical outcomes, as dosing is done via a reactive ‘trial and error’ approach.
This project by University Hospitals of Leicester NHS Trust will implement a personalised PK/PD model-based approach to vancomycin (the treatment of choice for MRSA bloodstream infection) dosing.
Personalised dosing recognises that each individual has unique PK and PD characteristics, which are key to the effect the drug has. Studies have shown that personalised dosing results in significant and substantial improvements to mortality, risk and patient outcomes.
The method involves the use of a population PK/PD model of vancomycin implemented within a decision support software called DoseMe®. Using basic demography and real-time clinical data, an individual’s PK/PD profile can be identified and hence the prescriber can predict the individual’s optimum dose of vancomycin.
The project will evaluate the feasibility of implementing personalised vancomycin dosing into routine clinical practice at the 22-bed adult and eight-bed paediatric ICUs at Glenfield Hospital. These ICUs treat approximately 200 patients per year with vancomycin.
For more information about this project, please contact Dr Hussain Mulla, Senior Clinical Pharmacist and Researcher in Clinical Pharmacology, University Hospitals of Leicester NHS Trust.