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Continuous versus intermittent beta-lactam infusion in severe sepsis: a meta-analysis of individual patient data from randomized trials

Roberts, Jason A. and Abdul Aziz, Mohd. Hafiz and Davis, Joshua S. and Dulhunty, Joel M. and Cotta, Menino O. and Myburgh, John and Bellomo, Rinaldo and Lipman, Jeffrey (2016) Continuous versus intermittent beta-lactam infusion in severe sepsis: a meta-analysis of individual patient data from randomized trials. American Journal of Respiratory and Critical Care Medicine, 194 (6). pp. 681-691. ISSN 1073-449X

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Abstract

Measurements and Main Results: We identified three randomized controlled trials in which researchers recruited a total of 632 patients with severe sepsis. The two groups were well balanced in terms of age, sex, and illness severity. The rates of hospital mortality and clinical cure for the continuous versus intermittent infusion groups were 19.6% versus 26.3% (relative risk, 0.74; 95% confidence interval, 0.56–1.00; P = 0.045) and 55.4% versus 46.3% (relative risk, 1.20; 95% confidence interval, 1.03–1.40; P = 0.021), respectively. In a multivariable model, intermittent β-lactam administration, higher Acute Physiology and Chronic Health Evaluation II score, use of renal replacement therapy, and infection by nonfermenting gram-negative bacilli were significantly associated with hospital mortality. Continuous β-lactam administration was not independently associated with clinical cure. Conclusions: 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.

Item Type: Article (Journal)
Additional Information: 6561/50325
Uncontrolled Keywords: antibiotic, clinical outcome, meropenem, pharmacodynamics, pharmacokinetics
Subjects: R Medicine > R Medicine (General)
R Medicine > RM Therapeutics. Pharmacology
R Medicine > RS Pharmacy and materia medica
Kulliyyahs/Centres/Divisions/Institutes: Kulliyyah of Pharmacy > Department of Pharmacy Practice
Depositing User: Mohd Hafiz Abdul Aziz
Date Deposited: 02 Nov 2016 14:15
Last Modified: 03 Oct 2017 14:48
URI: http://irep.iium.edu.my/id/eprint/50325

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