Beta-lactam underdosing is not more frequent in COVID-19 than in non-COVID-19 critically ill patients - 11/12/25
, Emmanuel Bourgogne b, g
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Highlights |
• | Beta-lactam underdosing has frequently occurred in ICU patients, regardless of their COVID-19 status. |
• | No significant difference in plasma beta-lactam levels has been found between COVID-19 and non-COVID-19 patients. |
• | Antibiotic underdosing may not fully explain higher rates of VAP treatment failure previously reported in COVID-19 patients. |
Abstract |
Objectives |
COVID-19 has been associated with high rates of ventilator-associated pneumonia relapse. Antibiotic underdosing due to augmented renal clearance (ARC) has been suggested as a possible contributing factor. This retrospective study compared plasmatic beta-lactam concentrations between critically-ill COVID-19 and non-COVID-19 patients.
Patients and methods |
We included measurements for cefotaxime, ceftazidime, cefepime and piperacillin. A multivariable logistic regression model was used to identify variables associated with underdosing.
Results |
All in all, 361 samples were included from 126 patients. Median concentrations did not differ between COVID-19 and non-COVID-19 patients for any molecule, nor did the rate of underdosing (38 % vs 42 %, p = 0.68). In a logistic regression model adjusting for age, gender, BMI, creatinine clearance and type of beta-lactam molecule, COVID-19 status was not associated with underdosing (OR = 0.83 [0.38–1.83], p = 0.997).
Conclusions |
Although underdosing of most commonly prescribed beta-lactams occurred in more than one third of cases in critically-ill COVID-19 patients, this rate did not differ from non-COVID-19 patients.
Le texte complet de cet article est disponible en PDF.Keywords : Antibiotic, Beta-lactam, Critically-ill patients, COVID-19, Pharmacokinetic
Abbreviations : BMI, C trough , CKD-EPI, ICU, OR
Plan
Vol 55 - N° 8
Article 105137- décembre 2025 Retour au numéro
Article précédent
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