[Advice on intravenous treatment with beta-lactams]

Beta-lactams (BL) are administered at present in dosages which are based only partly on controlled clinical investigations as these are difficult to carry out for all types of infections. Investigations of well-defined infections and animal experiments suggest that the optimal effect is obtained when the BL concentration is kept above the minimal inhibiting concentration (MIG) during treatment. In cases of intermittent BL treatment of serious infections and treatment of patients with compromised immune defence, it is considered advisable to keep the serum concentration constantly above the anticipated limit of sensitivity or MIC. On the basis of a review of the most important pharmacokinetic properties of BL, methods of measurement of the sensitivity of bacteria to BL and development of bacterial resistance to BL, a method is presented of calculating the individual doses and the intervals between doses as regards the sensitivities of the commonest human pathological bacteria to BL although the proposed dosages have not been tested clinically for all types of infections. Employing this, BL may easily be administered individually according to the severity of the infection and possible special conditions in the underlying disease in the patients. The individual doses and intervals between doses recommended in The Danish Medical Codex from 1988 are presented in tabular form and are compared with calculations of the time in which the serum concentration remains above the anticipated limit of sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)