Development of resistance during antimicrobial therapy is common.

For the special patient populations studied in this application - adult and paediatric ICU patients, burns, cystic fibrosis, obese, post-transplant, pneumonia and patients receiving renal replacement therapy - prolonged hospital stays are common, exposing the patient to more infections and more antimicrobial courses.

Our previous studies of common antimicrobials, piperacillin and meropenem, have quantified major pharmacokinetic alterations in adult ICU patients, whereby they display a unique spectrum of plasma concentration time profiles. There is a clinical imperative to describe the impact of these altered and highly variable antimicrobial exposures on bacterial killing and the emergence of resistance. This project addresses this considerable knowledge gap and will determine how contemporary antimicrobial dosing in these special patient populations leads to the emergence of resistance.