Perceptions and practices for beta‐lactam antibiotic dosing, administration, and monitoring in critically ill patients: Current views and use among critical care and infectious diseases pharmacists

Abstract

PurposeTo elucidate considerations that infectious diseases (ID) and critical care (CC) pharmacists have regarding beta‐lactam antibiotics in critically ill adult patients in order to identify areas for practice improvement and future research.Materials and MethodsA 17‐item survey was distributed to ID and CC pharmacists. Responses were characterized using frequency and descriptive statistics. Categorical variables were compared using χ2 or Fisher's exact test, as appropriate.ResultsNinety‐five of 834 ID pharmacists (11.4%) and 221 of 1436 CC pharmacists (15.4%) participated. Compared with ID pharmacists, more CC pharmacists would administer renally‐excreted beta‐lactams in critically ill patients with reduced renal function without dosage adjustment for 24 hours (17% vs 34%, P = 0.002). Most respondents believed therapeutic drug monitoring would be somewhat/very important in all surveyed scenarios. ID pharmacists more frequently believed antimicrobial stewardship teams should conduct prospective audits for definitive beta‐lactam therapy (98% vs 86%, P = 0.001), develop protocols for beta‐lactam use (95% vs 85%, P = 0.019), recommend beta‐lactam dosing (98% vs 85%, P < 0.001), and recommend empirical beta‐lactam selection (95% vs 81%, P = 0.001) compared with CC pharmacists.ConclusionBeta‐lactam dosing and monitoring recommendations in critically ill adults were frequently similar between pharmacy specialties. Research should be conducted in areas where opinions differ between specialties.