• Int. J. Antimicrob. Agents · Jun 2016

    Should β-lactam antibiotics be administered by continuous infusion in critically ill patients? A survey of Australia and New Zealand intensive care unit doctors and pharmacists.

    • Menino O Cotta, Joel M Dulhunty, Jason A Roberts, John Myburgh, and Jeffrey Lipman.
    • Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; Burns, Trauma & Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia; School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: m.o.cotta@uq.edu.au.
    • Int. J. Antimicrob. Agents. 2016 Jun 1; 47 (6): 436-8.

    AbstractAlthough there is a biological precedent for administration of β-lactam antibiotics by continuous or extended infusion, there is no definitive evidence of a survival benefit compared with intermittent administration. The aim of this study was to explore clinician uncertainty with regard to the administration of β-lactam antibiotics by continuous infusion. Doctors and pharmacists in Australian and New Zealand intensive care units (ICUs) were surveyed to investigate current β-lactam antibiotic administration practices as well as the degree of uncertainty regarding the benefit of continuous infusion of two commonly used broad-spectrum β-lactams, namely meropenem and piperacillin/tazobactam (TZP). There were 111 respondents to the survey. Intermittent infusion was reported as standard practice for meropenem (73.9%) and TZP (82.0%). A greater proportion of pharmacists compared with doctors believed continuous infusion to be more effective than intermittent administration (85.4% vs. 34.3%, respectively; P <0.001). Both groups reported uncertainty as to whether administration by continuous infusion resulted in better patient outcomes (65.9% and 74.6%, respectively; P = 0.85). Overall, 91.0% of respondents were prepared to enrol eligible patients into a definitive randomised controlled trial on β-lactam antibiotic administration. In conclusion, there is equipoise among clinicians working in Australian and New Zealand ICUs as to whether administration by continuous infusion offers a survival benefit in critically ill patients. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

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