A European project to test an innovative method

The researchers’ theory hinged on the following point: if patients were given doses of antibiotics at their bedside and these doses were rapidly adapted according to the patients’ physiological state, this would make it possible to improve and speed up healing rates for the patients concerned. The ideal solution would be to find the curative dose of antibiotics to apply during the entire treatment period for the patient. Currently, this is not the case because the volume of distribution of antibiotics can vary considerably according to the patient’s state. Although an overdose of antibiotics makes it possible to kill bacteria, this can also be toxic for humans. “This can cause neurological complications for example, and when the dose is not sufficient, the antibiotic does not kill the bacteria and this enables the selection of  bacteria  resistant to this medicine. For best results, the concentration of antibiotics in the patient’s blood must be in line with the curative concentrations at all times”, continues Bernard Joris. The objective of the MedATR project was to develop a dosing method for beta-lactam antibiotics at the bedside of patients. The somewhat encouraging results of this project have led to a worldwide patent (and a licensing agreement with the Wallonia-based company WOW Technology) and the establishment of a European FP7 project coordinated by Bernard Joris: MON4STRAT. This was launched in February for a duration of 4 years and consists of a clinical study aiming to verify the therapeutic interest of the rapid dosing method for the beta-lactam antibiotic levels developed for patients within the framework of the MedATR project. “Today the only method for measuring the dose of antibiotics in a sample is to send the sample to  a biochemistry  laboratory that uses the HPLC technique coupled with mass spectrometry to determine  the blood antibiotic concentration. Results are obtained only  around 24 hours after the sample has been administered and these sometimes no longer reflect the patient’s state”, explains Bernard Joris.

The first stage: a system adapted to intensive care!

In order to be able to rapidly adapt the dose of antibiotics in accordance with the patient’s physiological state, the researchers called upon the WOW Technology Company which has developed a particular device. “It is functional but cannot be used in an intensive care ward at this point”, indicates Bernard Joris. The first stage of the MON4STRAT project will consist of the creation of a machine on a trolley that can be easily used in the intensive care wards of hospitals. “This equipment should be finalized in 2015”, says Bernard Joris.

Following assessment of the dosing method, a supporting software programme for decision-making will be developed and nurses will be trained on how to use the dosing equipment. The principle is simple: a blood sample is taken, then poured on to the equipment which will give readings after around thirty minutes and also a suggestion for adapting the dose of antibiotics to the patient’s physiological state.

Once these different aspects are adjusted, the effects of almost instantaneous patient care in partner hospitals to the project in Brussels, Madrid, Paris, Lille and Tartu (Estonia) can begin to be assessed. “According to our estimates, the study will involve 150 ventilated and intubated adult patients who have contracted pneumonia in hospital”, says the scientist. Half of the patients will be treated “normally” and will represent the control group during the clinical study. The other half will have their antibiotic doses adjusted according to the principle of this new innovative method.