35 research outputs found

    Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

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    Objectives:We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged-infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT(> MIC) (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving beta-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of >= 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections

    PARTITION DEPENDENCE IN DECISION ANALYSIS, RESOURCE ALLOCATION AND CONSUMER CHOICE

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    essays on the effects of partition dependence on a number of domain

    The hand of corporate management in capital allocations: patterns of investment in multi- and single-business firms

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    One of Chandler’s basic insights was that the new organizational structures adopted after the 1920s reflected a specialization of the roles of business and corporate managers. Business managers coordinated functions and corporate managers allocated resources. This article studies the impact of corporate management on capital allocation decisions by comparing investment behavior in multi- and single-business companies. Using a new taxonomy to control for the quality of each business unit, we analyze a cross-sectional sample of U.S. companies and identify a number of empirical regularities that highlight the allocative decisions of corporate management. In particular, we find that, when dealing with cash-needy businesses, multi-business firms invest more intensively in those that are less profitable. We find no evidence that this subsidy results in a higher success rate in making those businesses profitable over time. We suggest a number of explanations for this empirical pattern

    Corporate capital allocation: a behavioral perspective

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    Previous research on capital investment has identified a tendency in multi-business firms toward cross-subsidization from well performing to poorly performing divisions, a phenomenon that has previously been attributed to principal-agent conflicts between headquarters and divisions (Stein, 2003). In this paper we argue that cross-subsidization reflects a more general tendency toward even allocation over all divisions in multi-business firms that is driven at least in part by the cognitive tendency to naïvely diversify when making investment decisions (Benartzi and Thaler, 2001). We observe that this tendency also leads to partition dependence in which capital allocations vary systematically with the divisions and subdivisions into which the firm is organized or over which capital is allocated. Our first study uses archival data to show that firms’ internal capital allocations are biased toward equality over the number of business units into which the firm is partitioned. Two further experimental studies of experienced managers examine whether this bias persists when participants are asked to allocate capital to various divisions of a hypothetical firm. This methodology eliminates the possibility of agency conflicts. Nevertheless, allocations varied systematically with the divisional and subdivisional structure of the firm, and whether capital was allocated in a centralized or decentralized manner
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