Figure 4

Examples of inter-occasion variability in antibiotic pharmacokinetics. (a) Admission to the intensive care unit (ICU) after coronary artery bypass grafts and valve repair, requiring mechanical ventilation and vasopressors for hypotension (not attributed to sepsis). This patient received higher-intensity continuous renal replacement therapy (CRRT) and did not survive to hospital discharge. Meropenem (1 g) was administered on each occasion. (b) Admission to the ICU from the emergency department and subsequently diagnosis with Klebsiella sepsis associated with a soft tissue infection, complicated by edema and hypoalbuminemia (24 g/L). Treatment included mechanical ventilation, antibiotics, and dopamine infusion (decreasing requirements during admission, not required at the time of second samples). This patient received higher-intensity CRRT and was alive at 90 days post-admission. Ciprofloxacin (200 mg) was administered on both occasions. CL, clearance; Vd, volume of distribution.