Consensus Guidance for Beta‐Lactam Antibiotic Dose Individualization in Acutely Ill Patients: Endorsed by the American College of Clinical Pharmacy, European Society of Clinical Microbiology and Infectious Diseases, European Society of Clinical Microbiology and Infectious Diseases PK/PD of Anti‐Infectives Study Group, Infectious Diseases Society of America, International Association of Therapeutic Drug Monitoring and Clinical Toxicology, Society of Critical Care Medicine, and the Society of Infectious Diseases Pharmacists
Abstract
Beta‐lactam antibiotics (beta‐lactams) are first‐line treatments for most major infectious syndromes in acutely ill patients, with in vitro activity against common pathogens, demonstrated efficacy in trials, and a perceived low risk of adverse effects. The current dosing approach, informed by population‐level data, tends to be simplistically reduced to a “one size fits all” dosing method which only accounts for body weight (i.e., in pediatrics) and end organ function to estimate drug clearance (e.g., estimated glomerular filtration rate); this approach results in substantial variability in observed serum concentrations in acutely ill patients, which can compromise real‐world effectiveness and safety. Beta‐lactam dose individualization, therefore, defined as a dosing regimen for one patient informed by measured concentrations from that patient, has been recommended in international clinical guidelines. Comprehensive guidance on best practices for beta‐lactam dose individualization is lacking. To address this knowledge gap and develop guidance, a multidisciplinary panel of international experts was assembled from the disciplines of infectious diseases, critical care, pharmacometrics, and laboratory medicine, representing both adults and pediatrics. The panel systematically evaluated the literature, using the GRADE approach where feasible, to address broad thematic questions pertaining to whether beta‐lactam dose individualization should be pursued, for what indications beta‐lactam dose individualization is warranted, and the most critical considerations and best practices for implementation of beta‐lactam individualization. The resultant consensus recommendations will equip healthcare professionals caring for acutely ill patients treated with beta‐lactam therapy with the evidence and tools necessary to guide optimal use of beta‐lactam dose individualization.
Related
- Focused Update to International Consensus Recommendations for the Use of Prolonged‐Infusion Beta‐Lactam Antibiotics Among Severely Ill Adult Patients: Endorsed by the American College of Clinical Pharmacy, British Society for Antimicrobial Chemotherapy, Cystic Fibrosis Foundation, European Society of Clinical Microbiology and Infectious Diseases, Infectious Diseases Society of America, Society of Critical Care Medicine, and Society of Infectious Diseases Pharmacists
- Association Between Patient Body Mass Index and Preferred Interpersonal Distance From Pharmacists.
- Exploring the factors influencing pharmacists' therapeutic reasoning in decision-making: a concurrent think aloud and semi-structured interview study
- Infectious disease communication for international students: A survey of association-accredited Japanese language schools in Japan
- The transition of youth with diabetes from paediatric to adult diabetes care services: a consensus report of the joint working group of the International Society for Pediatric and Adolescent Diabetes (ISPAD), the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA)
BibTeX
@article{barreto2026consensus,
title = {{Consensus Guidance for Beta‐Lactam Antibiotic Dose Individualization in Acutely Ill Patients: Endorsed by the American College of Clinical Pharmacy, European Society of Clinical Microbiology and Infectious Diseases, European Society of Clinical Microbiology and Infectious Diseases PK/PD of Anti‐Infectives Study Group, Infectious Diseases Society of America, International Association of Therapeutic Drug Monitoring and Clinical Toxicology, Society of Critical Care Medicine, and the Society of Infectious Diseases Pharmacists}},
author = {Erin Barreto and Erin Mccreary and Rekha Pai Mangalore and Sonya Tang Girdwood and Rebecca Arriola and Cynthia Bens and Robert Bonomo and Andrea Edginton and Lisa Hong and Angela Huttner and Birgit Koch and Nicole Maranchick and Michael Neely and Charles Peloquin and Gauri Rao and Jason Roberts and Anka Röhr and Marc Scheetz and Audrey Schuetz and Paul Yarnold and Andres Zuluaga and Nathaniel Rhodes},
journal = {Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
year = {2026},
month = jul,
doi = {10.1002/phar.70181},
url = {https://hal.science/hal-05775322v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Consensus Guidance for Beta‐Lactam Antibiotic Dose Individualization in Acutely Ill Patients: Endorsed by the American College of Clinical Pharmacy, European Society of Clinical Microbiology and Infectious Diseases, European Society of Clinical Microbiology and Infectious Diseases PK/PD of Anti‐Infectives Study Group, Infectious Diseases Society of America, International Association of Therapeutic Drug Monitoring and Clinical Toxicology, Society of Critical Care Medicine, and the Society of Infectious Diseases Pharmacists
AU - Erin Barreto
AU - Erin Mccreary
AU - Rekha Pai Mangalore
AU - Sonya Tang Girdwood
AU - Rebecca Arriola
AU - Cynthia Bens
AU - Robert Bonomo
AU - Andrea Edginton
AU - Lisa Hong
AU - Angela Huttner
AU - Birgit Koch
AU - Nicole Maranchick
AU - Michael Neely
AU - Charles Peloquin
AU - Gauri Rao
AU - Jason Roberts
AU - Anka Röhr
AU - Marc Scheetz
AU - Audrey Schuetz
AU - Paul Yarnold
AU - Andres Zuluaga
AU - Nathaniel Rhodes
PY - 2026
DA - 2026/07/22
JO - Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
DO - 10.1002/phar.70181
UR - https://hal.science/hal-05775322v1
AB - Beta‐lactam antibiotics (beta‐lactams) are first‐line treatments for most major infectious syndromes in acutely ill patients, with in vitro activity against common pathogens, demonstrated efficacy in trials, and a perceived low risk of adverse effects. The current dosing approach, informed by population‐level data, tends to be simplistically reduced to a “one size fits all” dosing method which only accounts for body weight (i.e., in pediatrics) and end organ function to estimate drug clearance (e.g., estimated glomerular filtration rate); this approach results in substantial variability in observed serum concentrations in acutely ill patients, which can compromise real‐world effectiveness and safety. Beta‐lactam dose individualization, therefore, defined as a dosing regimen for one patient informed by measured concentrations from that patient, has been recommended in international clinical guidelines. Comprehensive guidance on best practices for beta‐lactam dose individualization is lacking. To address this knowledge gap and develop guidance, a multidisciplinary panel of international experts was assembled from the disciplines of infectious diseases, critical care, pharmacometrics, and laboratory medicine, representing both adults and pediatrics. The panel systematically evaluated the literature, using the GRADE approach where feasible, to address broad thematic questions pertaining to whether beta‐lactam dose individualization should be pursued, for what indications beta‐lactam dose individualization is warranted, and the most critical considerations and best practices for implementation of beta‐lactam individualization. The resultant consensus recommendations will equip healthcare professionals caring for acutely ill patients treated with beta‐lactam therapy with the evidence and tools necessary to guide optimal use of beta‐lactam dose individualization.
SN - 0277-0008
ER -