Journal article
A multicenter randomized trial of continuous versus intermittent β-lactam infusion in severe sepsis
JM Dulhunty, JA Roberts, JS Davis, SAR Webb, R Bellomo, C Gomersall, C Shirwadkar, GM Eastwood, J Myburgh, DL Paterson, T Starr, SK Paul, J Lipman, L Peck, H Young, C Boschert, J Fletcher, J Smith, K Nand, T Sara Show all
American Journal of Respiratory and Critical Care Medicine | AMER THORACIC SOC | Published : 2015
Abstract
Rationale: Continuous infusion of β-lactam antibiotics may improve outcomes because of time-dependent antibacterial activity compared with intermittent dosing. Objectives: To evaluate the efficacy of continuous versus intermittent infusion in patients with severe sepsis. Methods: We conducted a randomized controlled trial in 25 intensive care units (ICUs). Participants commenced on piperacillin-tazobactam, ticarcillin-clavulanate, or meropenem were randomized to receive the prescribed antibiotic via continuous or 30-minute intermittent infusion for the remainder of the treatment course or until ICU discharge. The primary outcome was the number of alive ICU-free days at Day 28. Secondary outc..
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Funding Acknowledgements
This study was endorsed by the Australian and New Zealand Intensive Care Society Clinical Trials Group and the Australasian Society for Infectious Diseases Clinical Research Network. The authors thank Sia Athanasas (Burns, Trauma and Critical Care Research Centre, The University of Queensland) for financial management; Celia Webby, Ben Phillis, and Ascar Yu (The University of Queensland) for contract administration; Parisa Glass and Dorrilyn Rajbhandari (The George Institute for Global Health) for assistance with study planning; Sharon Micallef (The George Institute for Global Health) for coordination of study monitoring; Maryam Correa, Ann Gould, Meg Harward, Sharon Micallef, and Kelly Thompson (The George Institute for Global Health) and Janine Stuart (Royal Brisbane and Women's Hospital) for study monitoring; Margaret Haughton, Julius Agbeve, Namitha Bobby, and Mayukh Samanta (QIMR Berghofer Medical Research Institute) for contribution to database design, data management, and data analysis; Simon Venville and Jia Qian Xu (Baxter Healthcare Pty Ltd) for preparatory work relating to study drug compounding in New South Wales; Maxine Krause (Royal Brisbane and Women's Hospital) for administrative support; and site pharmacists who assisted with study drug compounding.