6/28/23, 1:17 AM DOLPHIN Pathway Feedback Search Clinical Topics Home Studies DOLPHIN DOLPHIN Trial question What is the role of model-informed precision dosing of -lactam antibiotics and ciprofloxacin in critically ill patients? Study design Multi-center Open label RCT Population Characteristics of study participants 38.0% female N = 388 62.0% male 388 patients (149 female, 239 male) Inclusion criteria: adult patients admitted to the ICU who were treated with antibiotics Key exclusion criteria: pregnancy; antibiotic cessation before first blood sample collection; admittance for burn wounds, or receipt of study antibiotics as part of selective decontamination of digestive tract prophylaxis Interventions N=189 model-informed precision dosing (individualized dose and interval adjustments based on monitoring serum drug levels combined with pharmacometric modeling of -lactam antibiotics and ciprofloxacin) N=199 standard dosing (antibiotic dosing based on local guidelines and freely adjusted by attending physician) Primary outcome Intensive care unit length of stay 10.0 days 10 8 7.5 days https://web.pathway.md/studies/rec1UTgJL7HwpYJGk 1/2 6/28/23, 1:17 AM DOLPHIN Pathway 5.0 days 2.5 days No significant difference 0.0 days Model-informed precision dosing Standard dosing No significant difference in ICU length of stay (10 days vs. 8 days; aIRR 1.16, 95% CI 0.96 to 1.41) Secondary outcomes No significant difference in target attainment before intervention at day 1 (55.6% vs. 60.9%; aOR 0.78, 95% CI 0.52 to 1.18) No significant difference in death in the ICU (21.7% vs. 18.1%; aOR 1.21, 95% CI 0.74 to 2.02) No significant difference in death at day 28 (26.5% vs. 24.6%; aOR 1.04, 95% CI 0.65 to 1.66) Safety outcomes No significant difference in adverse events. Conclusion In adult patients admitted to the ICU who were treated with antibiotics, model-informed precision dosing was not superior to standard dosing with respect to ICU length of stay. Reference Tim M J Ewoldt, Alan Abdulla, Wim J R Rietdijk et al. Model-informed precision dosing of beta- lactam antibiotics and ciprofloxacin in critically ill patients: a multicentre randomised clinical trial. Intensive Care Med. 2022 Dec;48(12):1760-1771. Open reference URL https://web.pathway.md/studies/rec1UTgJL7HwpYJGk 2/2