Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Evaluation of the B-lactam antibiotic concentration in the early phase of treatment of patients with suspected sepsis at the emergency department

Areskog Lejbman, Ilja LU ; Torisson, Gustav LU orcid ; Resman, Fredrik LU and Sjövall, Fredrik LU orcid (2026) In Infection
Abstract

PURPOSE: Early administration of beta-lactam antibiotics is a crucial part in the treatment of sepsis and septic shock. Beta-lactams demonstrate time-dependent killing and therefore it is important to optimize the time above the minimal inhibitory concentration (MIC). An extra dose is recommended in threatening/suspected/confirmed septic shock. This study aimed to examine whether patients with suspected sepsis achieved adequate concentrations after the initial dose.

METHODS: A prospective observational study was conducted in patients with suspected sepsis at the emergency department, started on cefotaxime, piperacillin-tazobactam or meropenem. The primary endpoint was defined as trough serum concentration above EUCAST clinical... (More)

PURPOSE: Early administration of beta-lactam antibiotics is a crucial part in the treatment of sepsis and septic shock. Beta-lactams demonstrate time-dependent killing and therefore it is important to optimize the time above the minimal inhibitory concentration (MIC). An extra dose is recommended in threatening/suspected/confirmed septic shock. This study aimed to examine whether patients with suspected sepsis achieved adequate concentrations after the initial dose.

METHODS: A prospective observational study was conducted in patients with suspected sepsis at the emergency department, started on cefotaxime, piperacillin-tazobactam or meropenem. The primary endpoint was defined as trough serum concentration above EUCAST clinical breakpoints for Enterobacterales spp., during the whole dosing interval, 100% ƒT > MIC. Primary objective was the percentage of patients reaching 100% ƒT > MIC. Secondary objectives were how an eventual extra dose and patients related factors affected target attainment.

RESULTS: The study included 60 patients with a median age of 78 years. Of all patients, 73% (44/60) attained 100% ƒT > MIC. Nine patients received an extra dose of whom all attained target. Patients not attaining target were younger with median age (years) 68 vs 79 and had better renal function in terms of median creatinine (µmol/l) 74 vs 121 and median eGFR (mL/min) 84 vs 49.

CONCLUSION: In this study, 27% (16/60) of patients admitted to the emergency department with suspected sepsis did not meet the target of 100% ƒT > MIC. This suggests that the treatment regimens for patients admitted to the emergency department with suspected sepsis can be further improved.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Infection
publisher
Springer Science and Business Media B.V.
external identifiers
  • pmid:41893986
  • scopus:105034654989
ISSN
0300-8126
DOI
10.1007/s15010-026-02785-z
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
efe5779a-cb21-402e-a77d-bb92c8db8265
date added to LUP
2026-03-30 07:52:20
date last changed
2026-05-22 04:01:14
@article{efe5779a-cb21-402e-a77d-bb92c8db8265,
  abstract     = {{<p>PURPOSE: Early administration of beta-lactam antibiotics is a crucial part in the treatment of sepsis and septic shock. Beta-lactams demonstrate time-dependent killing and therefore it is important to optimize the time above the minimal inhibitory concentration (MIC). An extra dose is recommended in threatening/suspected/confirmed septic shock. This study aimed to examine whether patients with suspected sepsis achieved adequate concentrations after the initial dose.</p><p>METHODS: A prospective observational study was conducted in patients with suspected sepsis at the emergency department, started on cefotaxime, piperacillin-tazobactam or meropenem. The primary endpoint was defined as trough serum concentration above EUCAST clinical breakpoints for Enterobacterales spp., during the whole dosing interval, 100% ƒT &gt; MIC. Primary objective was the percentage of patients reaching 100% ƒT &gt; MIC. Secondary objectives were how an eventual extra dose and patients related factors affected target attainment.</p><p>RESULTS: The study included 60 patients with a median age of 78 years. Of all patients, 73% (44/60) attained 100% ƒT &gt; MIC. Nine patients received an extra dose of whom all attained target. Patients not attaining target were younger with median age (years) 68 vs 79 and had better renal function in terms of median creatinine (µmol/l) 74 vs 121 and median eGFR (mL/min) 84 vs 49.</p><p>CONCLUSION: In this study, 27% (16/60) of patients admitted to the emergency department with suspected sepsis did not meet the target of 100% ƒT &gt; MIC. This suggests that the treatment regimens for patients admitted to the emergency department with suspected sepsis can be further improved.</p>}},
  author       = {{Areskog Lejbman, Ilja and Torisson, Gustav and Resman, Fredrik and Sjövall, Fredrik}},
  issn         = {{0300-8126}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Springer Science and Business Media B.V.}},
  series       = {{Infection}},
  title        = {{Evaluation of the B-lactam antibiotic concentration in the early phase of treatment of patients with suspected sepsis at the emergency department}},
  url          = {{http://dx.doi.org/10.1007/s15010-026-02785-z}},
  doi          = {{10.1007/s15010-026-02785-z}},
  year         = {{2026}},
}