Model for PK/PD of Antimicrobials in Blood Stream Infection: Feasibility

Inclusion Criteria:

• High probability of a blood stream infection; this is based on

• the presence of SIRS [Bone et al. 1992] defined by more than one of the followingclinical manifestations:

1. a body temperature greater than 38°C or less than 36°C

2. a heart rate greater than 90 beats per minute

3. tachypnea, manifested by a respiratory rate greater than 20 breaths perminute, or hyperventilation, as indicated by a PaCO2 of less than 32 mm Hg

4. an alteration in the white blood cell count, such as a count greater than 12,000/µl, a count less than 4,000/µl, or the presence of more than 10percent immature neutrophils ("bands"). and

• the assessment of the treating physician according to the patient's situationthat the SIRS is caused by an infection (e.g., patients after treatment withcytotoxic drugs)

• indication for antimicrobial treatment

• Intended use of one of the following antimicrobial agents: piperacillin/tazobactam; vancomycin; meropenem; ampicillin/sulbactam; flucloxacillin;ceftriaxone; caspofungin (according to the decision of the project coordinator, use ofother antimicrobial agents may also be included if anticipated to be used frequently)

• Age: 18 years or older (no upper limit)

• Willing and capable to provide written consent prior to enrolment after ampleinformation has been provided

Exclusion Criteria:

• expected chances to successfully carry out venipunctures to obtain the blood samplesrequired for the study are inadequately low according to the assessment of thephysician

• Anemia CTCAE grade >2 (i.e., Hb <8.0 g/dL / 4.9 mmol/L)

• the clinical status of the patients suggests that the anticipated treatment of thepatient or other conditions would make participation on the study inappropriate (e.g.,terminally ill patients); the respective assessment is done by the treating physician