Infusion of β-Lactam Antibiotics for Critically Ill Patients — Prolonged or Intermittent?

Continuous compared with standard intermittent infusion did not improve 90-day mortality, but benefits from prolonged infusion remain possible.

Prolonged infusion of β-lactam antibiotics maintains drug levels above the pathogen's minimum inhibitory concentration for a longer period. Does this approach improve outcomes? In a large, pragmatic multinational study (BLING III), investigators randomized 7022 patients in the intensive care unit (ICU) with a documented site of or strong suspicion of infection (median age, 59; 35% women; 59.5% with pneumonia, 40.8% with organism identified) to continuous or intermittent infusion of piperacillin-tazobactam or meropenem.

The primary endpoint of 90-day mortality did not differ between continuous (24.9%) and intermittent (26.8%) infusion. Several secondary outcomes — acquisition of drug-resistant organisms or Clostridioides difficile infection, …

Reviewing Authors

Hana M. El Sahly, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Hana M. El Sahly, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Raja-Elie E. Abdulnour, MD

Disclosures

Nothing to disclose

Raja-Elie E. Abdulnour, MD

Disclosures

Nothing to disclose

Infusion of β-Lactam Antibiotics for Critically Ill Patients — Prolonged or Intermittent?

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Reviewing Authors