Outcomes Equal for Continuous, Intermittent β-Lactams in Sepsis
No differences in ICU-free days, 90-day survival, organ failure-free days, bacteremia duration
WEDNESDAY, July 29, 2015 (HealthDay News) -- Continuous and intermittent administration of β-lactam antibiotics are similarly efficacious for patients with severe sepsis, according to a study published online July 22 in the American Journal of Respiratory and Critical Care Medicine.
Joel M. Dulhunty, Ph.D., from the Royal Brisbane and Women's Hospital in Australia, and colleagues examined the efficacy of continuous versus intermittent infusion of β-lactam antibiotics in patients with severe sepsis in a randomized trial conducted in 25 intensive care units (ICUs). Four hundred thirty-two patients started on piperacillin-tazobactam, ticarcillin-clavulanate, or meropenem were randomly allocated to receive the antibiotic via continuous or 30-minute intermittent infusion.
The researchers observed no difference in ICU-free days between the groups (18 days in the continuous group versus 20 days in the intermittent group; P = 0.38). No between-group differences were seen for 90-day survival (74.3 versus 72.5 percent; hazard ratio, 0.91; 95 percent confidence interval, 0.63 to 1.31; P = 0.61); clinical cure (52.4 versus 49.5 percent; odds ratio, 1.12; 95 percent confidence interval, 0.77 to 1.63; P = 0.56); or in organ failure-free days (six days; P = 0.27) or duration of bacteremia (zero days; P = 0.24).
"In critically ill patients with severe sepsis, there was no difference in outcomes between β-lactam antibiotic administration by continuous and intermittent infusion," the authors write.