Study of Beta-Lactam Antibiotic Dosing in Frail Elderly Patients Admitted to the Emergency and Geriatric Departments at Ghent University Hospital

What this Trial Is About

Researchers are evaluating whether current dosing regimens of beta-lactam antibiotics, including Amoxicillin-Clavulanate, Piperacillin-Tazobactam, and Temocillin, reach their pharmacodynamic targets in frail patients aged 75 years or older admitted to a geriatric department. This pilot, monocentric, prospective observational trial addresses a gap since older and frail patients are often excluded from drug studies, and their dosing is usually extrapolated from younger adults without considering differences in how the drugs behave in their bodies. The study involves administering these antibiotics intravenously using standard dosing schedules at Ghent University Hospital. Blood samples are collected through a catheter from the opposite arm of the infusion at early doses within the first 12 hours and steady state after 24 to 48 hours to measure drug concentrations. Bacteriological samples like blood cultures, urine, and sputum are also collected when possible, and various blood tests, including kidney function and infection markers, are performed. Frailty is assessed using three scoring systems KATZ, Geriatric 8, and Cumulative Illness Rating Scale. Participants receive standard care antibiotic therapy while researchers monitor drug levels, infection response, and pharmacodynamic target achievement over about one week. Up to five blood samples per dose are collected, with additional samples after therapy if needed. The study measures both total and unbound antibiotic concentrations and evaluates clearance and clinical response. This involves continuous monitoring of vital signs, blood results, and side effects to understand antibiotic behavior in this vulnerable population.

Antibiotic Dosing in Geriatric Patients At the Emergency Department