Prolonged Versus Intermittent Infusion of β-Lactam Antibiotics: A Systematic Review and Meta-Regression of Bacterial Killing in Preclinical Infection Models

@article{Dhaese2020ProlongedVI,
  title={Prolonged Versus Intermittent Infusion of $\beta$-Lactam Antibiotics: A Systematic Review and Meta-Regression of Bacterial Killing in Preclinical Infection Models},
  author={Sofie A.M. Dhaese and Aaron James Heffernan and David Liu and Mohd Hafiz Abdul-Aziz and Veronique Stove and Vincent H. Tam and Jeffrey Lipman and Jason Alexander Roberts and Jan J. De Waele},
  journal={Clinical Pharmacokinetics},
  year={2020},
  volume={59},
  pages={1237 - 1250}
}
Administering β-lactam antibiotics via prolonged infusions for critically ill patients is mainly based on preclinical evidence. Preclinical data on this topic have not been systematically reviewed before. The aim of this study was to describe the pharmacokinetic/pharmacodynamic (PK/PD) indices and targets reported in preclinical models and to compare the bactericidal efficacy of intermittent and prolonged infusions of β-lactam antibiotics. The MEDLINE and EMBASE databases were searched. To… Expand

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References

SHOWING 1-10 OF 59 REFERENCES
Continuous infusion vs. bolus dosing: implications for beta-lactam antibiotics.
TLDR
In vitro PK/PD data conclusively support the administration of beta-lactams via continuous infusion for maximizing bacterial killing from consistent attainment of pharmacodynamic end-points, and clinical outcome data supports equivalence, even with the use of a lower dose by continuous infusion. Expand
Continuous infusion of beta-lactam antibiotics in severe sepsis: a multicenter double-blind, randomized controlled trial.
  • J. Dulhunty, J. Roberts, +8 authors J. Lipman
  • Medicine
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2013
TLDR
Continuous administration of beta-lactam antibiotics achieved higher plasma antibiotic concentrations than intermittent administration with improvement in clinical cure, providing a strong rationale for further multicenter trials with sufficient power to identify differences in patient-centered endpoints. Expand
A Multicenter Randomized Trial of Continuous versus Intermittent β-Lactam Infusion in Severe Sepsis.
TLDR
In critically ill patients with severe sepsis, there was no difference in outcomes between β-lactam antibiotic administration by continuous and intermittent infusion. Expand
Prolonged versus short-term intravenous infusion of antipseudomonal β-lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials.
TLDR
Prolonged infusion of antipseudomonal β-lactams for the treatment of patients with sepsis was associated with significantly lower mortality than short-term infusion, and the quality of evidence for mortality was high. Expand
Impact of Bolus Dosing versus Continuous Infusion of Piperacillin and Tazobactam on the Development of Antimicrobial Resistance in Pseudomonas aeruginosa
TLDR
A stratified approach, according to bacterial density, is required to treat patients with nosocomial pneumonia, where antimicrobial monotherapy may be sufficient for some patients and alternative therapeutic strategies are required to maximize bacterial killing and prevent antimicrobial resistance. Expand
Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
TLDR
In critically ill patients with severe sepsis not receiving RRT, CI demonstrated higher clinical cure rates and had better PK/PD target attainment compared to IB dosing of beta-lactam antibiotics. Expand
In vivo pharmacodynamics of piperacillin/tazobactam: implications for antimicrobial efficacy and resistance suppression with innovator and generic products.
TLDR
It is estimated that use of TZP generics in a scenario of 25% therapeutic non-equivalence would result in extra expenses approaching US$1 billion per year in the USA owing to selection of resistant micro-organisms, greatly offsetting the savings gained from generic substitution and further emphasising the need for demonstrated and not assumed therapeutic equivalence. Expand
Continuous versus Intermittent β-Lactam Infusion in Severe Sepsis. A Meta-analysis of Individual Patient Data from Randomized Trials.
TLDR
Compared with intermittent dosing, administration of β-lactam antibiotics by continuous infusion in critically ill patients with severe sepsis is associated with decreased hospital mortality and factors associated with hospital mortality in multivariable analysis. Expand
Continuous versus intermittent infusions of antibiotics for the treatment of severe acute infections.
TLDR
The current evidence is insufficient to recommend the widespread adoption of continuous infusion antibiotics in the place of intermittent infusions of antibiotics, and the wide confidence intervals suggest that beneficial or harmful effects cannot be ruled out for all outcomes. Expand
Relationships between antimicrobial effect and area under the concentration-time curve as a basis for comparison of modes of antibiotic administration: meropenem bolus injections versus continuous infusions
TLDR
AUC analysis of the AME may be a useful tool for comparing different MAs and should be designed in a manner that provides the use of similar AUC ranges, since the AUC may be considered as a common pharmacokinetic denominator in comparing one MA or dosing regimen to another. Expand
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