Relationship of imipenem therapeutic drug monitoring to clinical outcomes in critically ill patients: a retrospective cohort study.

The primary objective of this study was to evaluate the predictors associated with target concentration (non-)attainment of imipenem in critically ill patients. The secondary objective was to explore the correlation between achieving imipenem target concentrations and clinical outcomes of therapy. A retrospective cohort study was conducted in critically ill patients treated with imipenem. Clinical data were extracted from the patients' electronic medical records. The pharmacokinetic/pharmacodynamic target was defined as free imipenem concentrations above the minimum inhibitory concentration (MIC) of the pathogen at 100% (100%fT>MIC) of the dosing interval. Factors associated with the non-attainment of target concentrations were evaluated using binomial logistic regression. Kaplan-Meier analysis was used to investigate the correlation between (non-)attainment targets and 30-day mortality. A total of 406 patients were included, and 55.4% achieved the target of 100%fT>MIC. Regression analysis identified an initial daily dose of imipenem ≤ 2 g/day, augmented renal clearance, age ≤ 60 years, recent surgery, and absence of positive microbiology culture as risk factors for target non-attainment. Achieving the 100%fT>MIC target was significantly associated with clinical efficacy but not with 30-day mortality. Selective application of therapeutic drug monitoring in the early stages of imipenem treatment for critically ill patients can improve clinical outcomes. Further research should explore the potential benefits of TDM-guided dosing strategies for imipenem in critical care settings.

Ice cream with sucralose, stevioside, and erythritol as sugar substitutes: Sensory profile and customer preference.

Sugar-free food has been gaining popularity because of low-calorie content. But sugar replacement by high-intensity sweeteners can negatively affect sensory. In this study, the effect of the addition of sucralose (Suc), stevioside (Ste), and erythritol (Ery) as sugar substitutes on the sensory profile and overall acceptance of ice cream were evaluated by penalty analysis (PA) based on the check-all-that apply (CATA) method, with those of the partial least squares (PLS) regression. Twelve sweetening agents of ice cream samples were presented to 106 consumers who answered on an overall liking question using the 15-point hedonic scale and a CATA question with 32 attributes that described the sensory characteristics of ice cream. The results showed that mixed sweeteners (60%Suc+20%Ste+20%Ery or 60%Suc+10%Ste+30%Ery) can present an advantageous performance when used separately, and making ice cream similar to that of sucrose (Sac) added. Adding Suc, Ste, and Ery to ice cream hardly felt bitterness, astringency, and chemical-like sensations of the sweetening agent. The significant difference between different sweeteners is the intensity and speed of sweetness. Developing combination of high-potency sweeteners that can make sweetness appear quickly could open up new ways to design sugar-free ice cream.