Related Experiment Video

Updated: Jan 7, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

13.3K

Prolonged Versus Intermittent Beta-Lactam Antibiotic Infusions in Paediatric Critical Care: A Systematic Review and

Kirsty O'Keefe1,2, Kerina J Denny1,2, Renate Le Marsney3

  • 1Gold Coast Intensive Care Unit, Gold Coast University Hospital, Gold Coast, Australia.

Journal of Paediatrics and Child Health
|December 27, 2025
PubMed

Insights

Prolonged beta-lactam infusions in pediatric intensive care units (PICUs) did not reduce mortality. Current evidence is limited and of low quality, indicating a need for more research on these antibiotic administration methods.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Suboptimal beta-lactam antibiotic dosing in pediatric intensive care units (PICUs) poses risks to critically ill children.
  • Optimizing antibiotic administration is crucial for improving patient outcomes in PICUs.

Purpose of the Study:

  • To evaluate the impact of prolonged beta-lactam infusions versus intermittent infusions on mortality, PICU length of stay, and pharmacokinetic/pharmacodynamic (PK/PD) parameters in PICU patients.
  • To synthesize existing evidence on the efficacy and safety of different beta-lactam infusion strategies in critically ill children.

Main Methods:

  • A systematic review and meta-analysis were conducted, searching multiple databases (MEDLINE, Cochrane, Embase, Web of Science).
  • Included studies compared prolonged beta-lactam infusions to intermittent infusions in PICU settings.
  • Risk of bias was assessed using the Robins-I tool; descriptive analysis was used when meta-analysis data were insufficient.

Main Results:

  • Ten observational studies involving 21-174 PICU patients were included.
  • No significant reduction in mortality was observed with prolonged infusions compared to intermittent infusions (OR 0.60; 95% CI 0.24, 1.51).
  • The overall quality of evidence was low, with a high risk of bias, and insufficient data for further meta-analyses.

Conclusions:

  • The current body of research on prolonged beta-lactam infusions in PICU patients is limited and of low quality.
  • Further high-quality research is necessary to determine the clinical benefits of prolonged beta-lactam infusions for severe infections in critically ill children.
Abstract

Keywords:
beta lactamchildrencontinuous infusionsintravenous infusionspaediatric intensive care

More Related Videos

A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii09:17

A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii

Published on: January 2, 2017

15.1K
Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung09:26

Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung

Published on: January 22, 2021

7.5K

Related Concept Videos

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
209
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
204
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
188
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
154
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
219
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
226