title: DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic.
abstract: BACKGROUND
  The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol.
  
  
  METHODS
  DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics.
  
  
  CONCLUSIONS
  The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.
authors: Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia. j.roberts2@uq.edu.au
authors: Jason A
authors: JA
authors: Roberts
authors: Jan J
authors: JJ
authors: De Waele
authors: George
authors: G
authors: Dimopoulos
authors: Despoina
authors: D
authors: Koulenti
authors: Claude
authors: C
authors: Martin
authors: Philippe
authors: P
authors: Montravers
authors: Jordi
authors: J
authors: Rello
authors: Andrew
authors: A
authors: Rhodes
authors: Therese
authors: T
authors: Starr
authors: Steven C
authors: SC
authors: Wallis
authors: Jeffrey
authors: J
authors: Lipman
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000494:pharmacology; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000494:pharmacology; D016638:Critical Illness; D016903:Drug Monitoring; D005060:Europe; D006801:Humans; D007362:Intensive Care Units; D010949:Plasma / Q000737:chemistry; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents