Centre for REdefining antibiotic use to reDUce resistanCE and prolong the lives of antibiotics (REDUCE) (2015–2020)

Abstract:
Infections in the healthcare setting are an unacceptable cause of high morbidity and mortality worldwide. Exceedingly common diseases and treatments that are frequently associated with infection include critical illness, burns, transplant, cystic fibrosis and immunosuppression. Infections in these patients are more difficult to treat leading to more multi-drug resistant infections which are associated with increased mortality and health costs. In Australia, critically ill, burns, transplant, and immunosuppressed patient groups have disproportionately higher antimicrobial prescription and yet worse infection outcomes than other patients. In part, this is due to sub-optimal antimicrobial dosing from a poor understanding of pharmacokinetics. It is now not uncommon for Australian clinicians to be confronted by a patient with completely resistant infection. We will use laboratory-based dynamic infection models to define antimicrobial concentrations that maximise bacterial killing and minimise the emergence of antimicrobial resistance (Objective 1). Objective 2 will conduct a series of clinical pharmacokinetic studies to characterise drug behaviour in the above challenging patient populations. Objective 3 will combine the data from the first two objectives into novel antimicrobial doses which can then be tested for patient safety in Objective 4. Objective 5 will involve some targeted clinical outcome studies based on novel antimicrobial dosing approaches. Objective 6 will develop a strategy to improve consumer participation in ICU-based research and Objective 7 will ensure rapid translation of the novel dosing strategies into NHMRC guidelines. Our team has world leading collaborative experience with infection models, clinical pharmacokinetics, pharmacometrics and clinical trials and will be able to define dosing regimens of our most commonly used antimicrobials that will maximise antimicrobial effectiveness inc...
Grant type:
NHMRC Centres of Research Excellence
Researchers:
Funded by:
National Health and Medical Research Council