Antibiootikumide doseerimine raskete infektsioonide korral
The main goal of the project is to clarify pharmacokinetics and –dynamics (PK/PD) of antibiotics applied for treatment of severe infections in immunocompromised persons, including premature neonates and adult intensive care patients. Severe infections are a primary threat for entire population. Immunocompromised critically ill patients form an especially difficult-to-treat population. Insufficient antibiotic levels in these patients may have immediate life-threatening impact or lead to development of antibiotic resistance in long term. Therefore, there is an urgent need for targeted antibiotic treatment regimens and precise therapeutic drug monitoring technologies applicable at bedside for closer adjustment of antibacterial therapies. At present, this kind of data and technologies are lacking. The present project includes 8 clinical studies, where PK/PD of selected carbapenems, piperacilin/tazobactam and penicillin G will be evaluated in neonatal or adult intensive care patients. We are also aimed to explore changes in gut microbiota during antibacterial treatment in ICU. These kinds of studies have never received sufficient priority from pharmaceutical companies and therefore remain a challenge for academic research. Clarifying of PK/PD of mentioned antibiotics, most commonly used for treatment of severe infections in critically ill patients, but also application of new methods of drug pharmacokinetics modelling, will allow us to build up practical recommendations for targeted antibiotic therapy in these highest risk patients. Implementation of new drug measurement methodology (allowing multiple measurements from very small sample volume) together with modelling approach will ensure maximum information gain with minimum distress and discomfort for the patients. The project involves cooperation between different institutions of the University of Tartu and different hospitals in Estonia (Tartu University Hospital, Tallinn Childrens’ Hospital, East Tallinn Central Hospital), as well as international collaboration with the aim to establish an internationally renowned research team with great potential for training high-level clinical researchers and spreading scientific thinking and knowledge in Estonian medicine. We are aimed to develop technological expertise for drug assays, which can be implemented in clinical practise.