Continuous vs. Intermittent Infusion of β-Lactam Antibiotics for Severe Sepsis

In patients with sepsis, antibiotics must be administered optimally. For β-lactam antibiotics, maximum killing of susceptible bacteria occurs when the concentration of free drug is three to four times the minimum inhibitory concentration against the microorganism. One potential way to achieve optimal concentration of β-lactam antibiotics is with continuous infusion, but its superiority to intermittent dosing has not always been clear in the medical literature.

At 25 intensive care units (ICUs) in Australia, New Zealand, and Hong Kong, 422 adults with severe sepsis who had started piperacillin–tazobactam, ticarcillin–clavulanate, or meropenem had their prescribed antibiotic administered, in randomized fashion, either continuously or via inter…