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Optimizing Betalactam Clinical Response by Using a Continuous Infusion: A Comprehensive Review
Sylvain Diamantis1,2, Catherine Chakvetadze1, Astrid de Pontfarcy1
1Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, 77000 Melun, France.
Introduction:
Antimicrobial resistance is a major healthcare issue responsible for a large number of deaths. Many reviews identified that PKPD data are in favor of the use of continuous infusion, and we wanted to review clinical data results in order to optimize our clinical practice.
Methodology:
We reviewed Medline for existing literature comparing continuous or extended infusion to intermittent infusion of betalactams.
Results:
In clinical studies, continuous infusion is as good as intermittent infusion. In the subset group of critically ill patients or those with an infection due to an organism with high MIC, a continuous infusion was associated with better clinical response.
Conclusions:
Clinical data appear to confirm those of PK/PD to use a continuous infusion in severely ill patients or those infected by an organism with an elevated MIC, as it is associated with higher survival rates. In other cases, it may allow for a decrease in antibiotic daily dosage, thereby contributing to a decrease in overall costs.
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