Prolonged infusions of β-lactam antibiotics: implication for antimicrobial stewardship

The optimal dosage and administration of antibiotics are not only important measures to combat antimicrobial resistance, but they are also integral to antimicrobial stewardship. In light of a diminishing antibiotic pipeline and an alarming rise in resistance, the optimal dosage and administration of antimicrobial agents have been under a great deal of scrutiny. Prolonged infusions of β-lactam antibiotics have been proposed as an alternate dosing strategy. To summarize the evidence on prolonged infusions of β-lactam agents and provide their clinical implications for antimicrobial stewardship, we performed a MEDLINE search (1950-2011) of all relevant articles. This article provides a review of data from Monte Carlo simulations, clinical outcome analyses, and pharmacoeconomic studies. Furthermore, protocol implementation strategies are discussed to address antimicrobial stewardship.