Midwestern University Researcher Helps Shape International Standards for Precision Antibiotic Dosing

Hospitals around the world now have new evidence-based recommendations to help personalize antibiotic treatment for critically ill patients, thanks in part to a Midwestern University faculty member who co-led an international expert panel. Published in Pharmacotherapy and endorsed by seven leading healthcare organizations, the consensus guidance addresses one of the most commonly prescribed classes of antibiotics for serious infections.

Nathaniel "Jim" Rhodes, Pharm.D., M.Sc., BCPS-AQ Infectious Diseases, Professor of Pharmacy Practice at Midwestern University's College of Pharmacy, Downers Grove, and Clinical and Computational Science Lead for the University's Pharmacometrics Center of Excellence, co-led an international panel of experts that developed new consensus guidance for individualizing beta-lactam antibiotic dosing in acutely ill patients.

Why Individualized Dosing Matters

Beta-lactam antibiotics, which include penicillins, cephalosporins, and many other commonly prescribed antibiotics, are widely used to treat serious infections. However, patients often process these medications very differently. "Most beta-lactam dosing still relies on weight and kidney function—pretty blunt instruments," Dr. Rhodes said. "Drug levels can vary 10- to 30-fold between patients even when the standard dose looks right on paper. Given that up to 70% of patients with sepsis receive a beta-lactam antibiotic, that variability has real clinical consequences."

The guidance recommends using patient-specific information, including blood tests that measure antibiotic levels, to help clinicians determine the right dose for each patient. The goal is to make treatment more effective while reducing the risk of giving too little or too much medication.

International Experts Develop New Guidance

As co-chair alongside Erin Barreto, Pharm.D., M.S., of Mayo Clinic, Dr. Rhodes led a three-and-a-half-year international collaboration involving 19 experts from multiple disciplines and countries to develop the consensus recommendations.

"Coordinating experts across multiple countries and disciplines was a long process, but that's why these recommendations carry weight," Dr. Rhodes said. "The systematic review, evidence evaluation, and endorsement process ensure that hospitals can have confidence in the guidance."

One of the review's strongest findings was that individualized beta-lactam dosing nearly doubled the likelihood of a successful clinical outcome compared with standard dosing, Dr. Rhodes said. "For hospitals with the interest and capacity, this guidance provides a real playbook. It identifies which patients should be prioritized and gives clinicians the tools to implement individualized dosing effectively," he added.

Advancing Precision Dosing at Midwestern

The work also reflects the mission of Midwestern University's Pharmacometrics Center of Excellence, which focuses on developing individualized medication dosing strategies to improve patient care. "Dose individualization has been a core focus of the Pharmacometrics Center of Excellence for years," Dr. Rhodes said. "This guidance reflects the work we've been doing at Midwestern on an international scale."

The consensus guidance, Consensus Guidance for Beta-Lactam Antibiotic Dose Individualization in Acutely Ill Patients, appears in Pharmacotherapy, the official journal of the American College of Clinical Pharmacy.