Management Of Burn Injury: Fluid Dynamics And Antibiotic Pharmacokinetics
Funder
National Health and Medical Research Council
Funding Amount
$342,375.00
Summary
It is well known that major burns, as well as being relatively common injuries, are notoriously difficult to manage. Patients exhibit significant variability due to a combination of anatomic, physiologic, hormonal and immunologic alterations occurring both at the wound site and, more importantly, in other body compartments and vital organ systems. Skin burn injury results in the release of multiple inflammatory mediators in addition to significant fluid loss. The distribution of inflammatory med ....It is well known that major burns, as well as being relatively common injuries, are notoriously difficult to manage. Patients exhibit significant variability due to a combination of anatomic, physiologic, hormonal and immunologic alterations occurring both at the wound site and, more importantly, in other body compartments and vital organ systems. Skin burn injury results in the release of multiple inflammatory mediators in addition to significant fluid loss. The distribution of inflammatory mediators and wound bacteria to central organs can cause complex physiological changes that may lead to multiple organ failure, with serious infections occurring in around 50% of patients with serious burns. Antibiotic distribution kinetics, such as bioavailability, clearance, volume of distribution, elimination half-life and unbound fraction in plasma can be significantly altered in burn patients. Without detailed knowledge of changes and relationships between factors such as wound pH, tissue oxygenation, protein concentrations of fluid leaked from the local wound microvasculature, tissue binding, oedema and changes in burned and non-burned tissue induced by resuscitation therapies, the optimisation of both local and systemic infection contriol therapies can hardly be expected to advance. This project aims to determine how changes the physiology of burn patients, in particular in the burn wound environment, affect antibiotic penetration and distribution into tissues. We also believe that these changes will vary between patients and are aiming to determine whether certain parameters can be used to give an indication of the best antibiotic dosing regimens for individual patients.Read moreRead less
BLING III: A Phase III Randomised Controlled Trial Of Continuous Beta-lactam Infusion Compared With Intermittent Beta-lactam Dosing In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$3,269,943.00
Summary
This Australian-led trial of global significance will provide definitive clinical evidence of the optimal method for treating patients with severe sepsis using beta-lactam antibiotics. The trial will compare whether continuous infusion of beta-lactam antibiotics improves outcomes for patients compared with standard intermittent dosing. The potential significance of this trial is that it may lead to a simple and cost-effective intervention to improve survival for patients with severe infections.
A Phase IIb Randomised Controlled Trial Of Continuous Beta-lactam Infusion Compared With Intermittent Beta-lactam Dosing In Critically Ill Patients With Severe Sepsis
Funder
National Health and Medical Research Council
Funding Amount
$947,371.00
Summary
This randomised controlled trial aims to compare, in critically-ill patients with severe sepsis managed in the intensive care unit, whether the administration of beta-lactam antibiotics via continuous infusion improves outcomes for patients compared with standard intermittent dosing. The potential significance of this step-wise research program is that it may lead to a simple and cost-effective intervention to improve ICU-free days, clinical cure and survival for patients with severe infections.