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Maximum bactericidal activity of β-lactam antibiotics is dependent on maintaining drug concentrations above the minimum inhibitory concentration of the targeted organisms. Although continuous infusion of antibiotics theoretically could offer superior outcomes compared with intermittent dosing, several underpowered randomized controlled trials have failed to demonstrate such an effect.
In this meta-analysis, investigators aggregated 632 patients from three randomized trials in which a continuous-infusion dosing strategy for β-lactams was compared with an intermittent-infusion dosing strategy in critically ill patients with sepsis (formerly “severe sepsis”; NEJM JW Hosp Med Apr 2016 and JAMA 2016; 315:762, 775, 801) or shock. Continuous-infusi…