2023
DOI: 10.1080/14787210.2023.2184347
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Continuous infusion of beta-lactam antibiotics: narrative review of systematic reviews, and implications for outpatient parenteral antibiotic therapy

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Cited by 16 publications
(13 citation statements)
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“…The study may support the relevance that a real-time TDM-guided ECPA approach may have even in the surgical setting, as recently suggested [ 18 ]. CI is the best administration mode for attaining aggressive PK/PD targets with beta-lactam under the same daily dose [ 19 , 20 , 21 , 22 , 23 ]. Furthermore, some studies reported significantly lower mortality rates, higher clinical cure rates, and higher microbiological eradication rates with the administration of beta-lactams via CI compared to intermittent infusion [ 19 , 20 , 21 , 22 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The study may support the relevance that a real-time TDM-guided ECPA approach may have even in the surgical setting, as recently suggested [ 18 ]. CI is the best administration mode for attaining aggressive PK/PD targets with beta-lactam under the same daily dose [ 19 , 20 , 21 , 22 , 23 ]. Furthermore, some studies reported significantly lower mortality rates, higher clinical cure rates, and higher microbiological eradication rates with the administration of beta-lactams via CI compared to intermittent infusion [ 19 , 20 , 21 , 22 ].…”
Section: Discussionmentioning
confidence: 99%
“…CI is the best administration mode for attaining aggressive PK/PD targets with beta-lactam under the same daily dose [ 19 , 20 , 21 , 22 , 23 ]. Furthermore, some studies reported significantly lower mortality rates, higher clinical cure rates, and higher microbiological eradication rates with the administration of beta-lactams via CI compared to intermittent infusion [ 19 , 20 , 21 , 22 ]. Noteworthy a large proportion of our urologic patients were elderly with moderate-to-severe renal dysfunction, and the TDM-guided approach of CI piperacillin–tazobactam and meropenem allowed optimal PK/PD target attainment, even by consistently decreasing dosages in several cases, thus minimizing clinically unnecessary drug overexposure and the risk of concentration-dependent neurotoxicity [ 24 , 25 ].…”
Section: Discussionmentioning
confidence: 99%
“…For β-lactams, a free drug concentration above the minimum inhibitory concentration (fT > MIC) is the pharmacodynamic parameter related to antibiotic activity, i.e., they are time-dependent antibiotics. Prolonged infusion time is a strategy used to increase the percentage of dosing intervals in which fT > MIC [ 34 ], so there is strong evidence that supports and recommends the use of β-lactams in continuous infusion, especially in critical patients and complicated or difficult-to-access infections [ 35 ]. AMP is a β-lactam commonly used to treat infections requiring long-term hospitalization, being one of the preferred treatment options in infective endocarditis caused by Enterococcus [ 36 ], the third causative pathogen of this disease.…”
Section: Discussionmentioning
confidence: 99%
“…So far, cefiderocol is applied as a prolonged 3‐h infusion, in accordance with the present dosing recommendations 7 . However, the therapeutic target of cefiderocol suggests that continuous intravenous administration may be advantageous, as fluctuations in systemic concentrations will be reduced and it is more likely to achieve the optimal target of 100% of fT > MIC 14 . Moreover, these extended infusions are favourable as treatment of severe infections due to a decrease in mortality without a rise in adverse events 15 .…”
Section: Introductionmentioning
confidence: 92%
“…7 However, the therapeutic target of cefiderocol suggests that continuous intravenous administration may be advantageous, as fluctuations in systemic concentrations will be reduced and it is more likely to achieve the optimal target of 100% of fT > MIC. 14 Moreover, these extended infusions are favourable as treatment of severe infections due to a decrease in mortality without a rise in adverse events. 15 This may be the most relevant for critically ill patients undergoing CRRT, due to the continuous clearance of cefiderocol and changes in pharmacokinetic and pharmacodynamic parameters.…”
mentioning
confidence: 99%