Critically ill patients often have varying physiological needs to an average patient and often require different dosages of antibiotics and other drugs, particularly if they are on renal replacement therapies. There is also a controversy over whether bolus dosing or continuous infusion of β-lactams is more effective in antibiotic delivery in critically ill patients. Prof Lipman has pioneered work that demonstrates that patients in intensive care are not receiving enough antibiotics to achieve optimal levels to kill pathogens. This in turn leads to poorer health outcomes for patients and antibiotic resistance. Antibiotic resistant infections commonly occur in long stay, debilitated patients and contribute to increased risk of death, longer ICU and hospital stay, further weakness and long term dysfunction. This problem also contributes to patients being unable to be discharged from ICU or hospital and so exacerbating the shortage of acute hospital beds and increases in surgery waiting time.

Current projects

  • Multi-centre Australian and New Zealand study of antibiotic utilisation in the ICU. Lipman J, Dulhunty J, Paterson D.
  • An International Epidemiological Study of Candidaemia in a Critical Care Population. Holley A, Dulhunty J, Lipman J, Dancer C.  Funder: RBWH Foundation
  • Multi-drug resistant Acinetobacter: an emerging nosocomial pathogen.  Schembri M, Lipman J, Nimmo G, McEwan A, Jennings M .  Funder: RBWH Foundation, RBWH
  • Membrane-targeted antibiotic for the treatment of skin and lung infections caused by drug resistant pathogens including MRSA, VISA, VRE and S. pneumoniae. Cooper MA, Paterson DL, Roberts JA, Schlaes D . Funder: Wellcome Trust Seeding Drug Discovery Award
  • Identifying a cost-effective approach to MRSA control in Australia. Halton K, Robotham J, Nimmo G, Barnett A, Graves N, Lipman J. Funder: NHMRC
  • Non-Haemolytic Friulimicins for the Treatment of Multi-Drug Resistant Bacteria. Cooper M, Roberts J, Butler M. Funder: NHMRC
  • Pharmacokinetics of cephalosporin antibiotics in peritoneal dialysis patients with peritonitis. Roberts J, Ranganathan D. Funder: RBWH, Australian and New Zealand College of Anaesthetists (ANZCA)
  • Pharmacokinetics of Enteric Coated Mycophenolate Sodium in Lupus Nephritis (POEMSLUN). Ranganathan D, Roberts J, John G, Fassett R, Healy H, Lipman J, Kubler P, Ungerer J. Funder: RBWH
  • DALI - Defining Antibiotic Levels in Intensive care unit patients. Lipman J, Wallis S, Roberts J, Dimopoulos G, Martin C, Rello J. Funder: RBWH, European Society of Intensive Care Medicine (ESICM).
  • Pilot Study of pharmacokinetic and pharmacodynamic assessment of monotherapy versus combination therapy for the management of gram negative bacteraemia. Avent M, Paterson D, Roberts J, Lipman J, Forest A, Kirkpatrick C, Ungerer J, McFarlane M. Funder: RBWH
  • Imaging of the microcirculation using the Microscan (orthogonal polarization spectral imaging) and providing improved quality of drug analysis for PK studies in critically ill patients.  Lipman J, Paratz J, Boots R, Muller M, Dalley A. Funder:  NHMRC/UQ, RBWH Foundation/Wormald
  • Study of the PK of inhaled antibiotics in lung tissue using the microdialysis technique. Dhanani J, Fraser J, Chew M, Roberts J, Paterson D. Funder: TPCH Foundation.
  • Continuous versus intermittent β-lactam antibiotic dosing in critically ill patients: determining the evidence via a step-wise program of research. Dulhunty J, Lipman J, Paterson D, Roberts J, Webb S,  Myburgh J, Bellomo R, Gomersall C, Davis J, Shirwadkar C. Funder: RBWH
  • An investigation of PK-PD characteristics of various β-lactam antibiotics in patients with sepsis using microdialysis. Peake S, Robertson T, Lipman J, Roberts J, Roberts M. Funder: The Queen Elizabeth Hospital (TQEH) Research Foundation
  • Pharmacokinetics of broad spectrum antibiotics in extracorporeal membrane oxygenation (ECMO) - using plasma concentrations to optimize antibiotic therapy. Welch S, Roberts J, Burrows F, Levkovich B, Ray J, Pellegrino V, Bui T, Wallis S, Marriott D, Rudham S. Funder: Society of Hospital Pharmacists of Australia (SHPA), RBWH Foundation
  • Facilitating the SOM as a central co-ordinator of global pharmacokinetics studies in critically ill patients. Lipman J, Roberts J, Paratz J, Paterson D, Fraser J. Funder: UQ MEI/NHMRC Equipment Grant
  • Disposition of sedative, analgesic and antibiotic drugs during ECMO. Mullany D, Shekar K, Roberts J, Smith M, Fraser J, McDonald C, Wallis S, Kramer H. Funder: ANZCA, Australia and New Zealand Intensive Care Society (ANZICS)
  • Pharmacokinetics of commonly used sedatives, analgesics, their metabolites and broad spectrum antibiotics during ECMO. Shekar S, Roberts J, Smith M, Wallis S, Thompson B, Pellegrino V, Buscher H, Welch S, Levkovich B. Funder: TPCH Foundation
  • Antibiotic, sedative and analgesic drug pharmacokinetics during ovine extracorporeal membrane oxygenation - understanding altered pharmacokinetics to improve patient outcomes. Shekar K, Roberts J, Smith M, Fung Y, Fraser J, Wallis S, Mullany D, Diab S, McDonald C, Barnet A, Ghassabian S, Platts D, Dunster K. Funder: ANZCA, TPCH Foundation, ANZICS
  • Randomised controlled trial of beta-lactam continuous infusion compared with intermittent dosing in critically ill patients. Dulhunty J, Lipman J, Starr T. Funder: RBWH Foundation
  • The Pharmacokinetics of Vancomycin, Meropenem and Piperacillin-Tazobactam in Critically Ill Patients undergoing Sustained Low-Efficiency Dialysis (SLED). Economou C. Funder: RBWH Scholarship
  • Ketorolac pharmacokinetics in joint replacements . Roberts J, Wallis S, Gurunathan U.
  • Sampling Antibiotics in Renal Replacement Therapy (SMARRT Study).  Roberts J,  Lipman J, Roberts M, Paul S, Peake S, Turnidge J.  Funder: NHMRC
  • Antibiotic adsorption and clearance during renal replacement therapy: an ex vivo study. Roberts J.
  • Pharmacokinetics in CVVHDF-using plasma and tissue antibiotic concentrations to optimize dosing of β-lactam antibiotics. Varghese J, Lipman J, Roberts J. Funder: RBWH Foundation
  • Does inhaled antibiotics deliver optimal concentrations to the lung to improve treatment of pneumonia. An animal in vivo study using the microdialysis technique. Dhanani J, Paterson D, Roberts J, Chew M, Fraser J. Funder: RBWH
  • Evaluation of inappropriate prescribing in elderly patients at the RBWH. Mulvogue K, Kanagarajah S, Coombes I, Roberts J. Funder: RBWH
  • Dosing to maximise bacterial killing and prevent resistance in ICU. Roberts J, Lipman J, Wallis S,  Kirkpatrick C, Landersdorfer C, Bulitta J, Bergen P. Funder: NHMRC
  • Piperacillin and cefazolin pharmacokinetics in sepsis and trauma. Roberts J, Lipman J, Udy A, Wallis S,  Kirkpatrick C, Kruger P, Roberts  M.
  • Stability of antibiotics in peritoneal dialysis solutions (STAB) Study. Roberts J, Lipman J, Wallis S, Ranganathan D. Funder: Baxter Healthcare
  • POEMSLUN - pharmacokinetic sub-study analysis evaluating total and free mycophenolic acid concentrations. Roberts J, Lipman J, Ranganathan D. Funder: RBWH Foundation
  • PARITY: Paracetamol in Traumatic Brain Injury. Principal Investigator: Gowardman J, Roberts J, Lipman J, Wallis S, Saxena M.
  • Continuous vs bolus cefazolin in abdominal surgery patients (collaboration with University of Virginia). Roberts J, Lipman J, Wallis S, Naik B, Ikeda K, Todorovic M.
  • Antibiotic pharmacokinetic study in renal replacement therapy - CVVHF vs CVVHDF (collaboration with CHU Nimes). Roberts J, Lipman J, Wallis S, Lefrant J-Y, Roger C, Muller L. Funder: Le Centre Hospitalier Universitaire de Nimes (CHU Nimes)
  • High-dose aminoglycosides in ICU patients and achievement of PK/PD targets (collaboration with CHU Nimes). Roberts J, Lefrant J-Y, Roger C, Muller L. Funder: CHU Nimes
  • Comparison of voriconazole population pharmacokinetic models. Roberts J, Farkas A, Dolton M, Han K.
  • Comparison of piperacillin population pharmacokinetic models. Roberts J, Lipman J, Wong G, Farkas A.
  • Levofloxacin pharmacokinetics analysis - ICU vs non-ICU ((with Udine, Italy). Roberts J, Lipman J,  Pea F, Cojutti P.
  • Vancomycin penetration into ELF of critically ill patients (Collaboration with Queen Elizabeth Hospital, Birmingham). Roberts J, Whitehouse T, Pemberton P.
  • Antibiotic pharmacokinetics in Slow Low Efficiency Dialysis (piperacillin, meropenem and vancomycin; collaboration with The Ottawa Hospital). Roberts J, Kanji S, Zelenitsky S.
  • Teiciplanin pharmacokinetics and protein binding in methicillin resistant S. aureus infection (collaboration with Trinity College Ireland). Roberts J, D'Arcy D, Byrne C.
  • Population pharmacokinetics of meropenem in critically ill patients and development of dosing software. (Collaboration with Liverpool University). Roberts J, Hope W, Belen A.
  • Population pharmacokinetics of cefepime and ceftazidime continuous renal replacement therapy (Collaboration with Erasme Hospital and Ghent University). Roberts J, Carlier M, Taccone F.
  • Meropenem and ciprofloxacin pharmacokinetics in ICU patients with shock (MaC-DIPPS). Roberts J, Lipman J, Sjovall F, Christrup L, Kreilgaard M, Perner A, Frimodt-Møller N.
  • Plasma and tissue pharmacokinetics of lincomycin in patients with burn wound infection. Muller M, Wang L, Roberts J, Lipman J. Funder: RBWH Foundation
  • An Investigation of the Pharmacokinetics of Pip/taz, Meropenem and Fluconazole in Critically Ill Obese Patients (PHANCO). Alobaid A, Roberts J, Lipman J, Roberts M. Funder: Saudi Arabian Cultural Mision

Researchers