Continuous Infusion of Beta-Lactam Antibiotics in Severe Sepsis: A Multicenter Double-Blind, Randomized Controlled Trial
Joel M Dulhunty, Jason A Roberts, Joshua S Davis, Steven AR Webb, Rinaldo Bellomo, Charles Gomersall, Charudatt Shirwadkar, Glenn M Eastwood, John Myburgh, David L Paterson, Jeffrey Lipman
CLINICAL INFECTIOUS DISEASES | OXFORD UNIV PRESS INC | Published : 2013
BACKGROUND: Beta-lactam antibiotics are a commonly used treatment for severe sepsis, with intermittent bolus dosing standard therapy, despite a strong theoretical rationale for continuous administration. The aim of this trial was to determine the clinical and pharmacokinetic differences between continuous and intermittent dosing in patients with severe sepsis. METHODS: This was a prospective, double-blind, randomized controlled trial of continuous infusion versus intermittent bolus dosing of piperacillin-tazobactam, meropenem, and ticarcillin-clavulanate conducted in 5 intensive care units across Australia and Hong Kong. The primary pharmacokinetic outcome on treatment analysis was plasma an..View full abstract
Awarded by National Health and Medical Research Council
This work was supported by the Intensive Care Foundation (2010); a Royal Brisbane and Women's Hospital Foundation grant to J. M. D. (2011); and National Health and Medical Research Council Training Research Fellowships to J. A. R. and J. S. D. (569917 and 1013411).J. A. R. has served as a consultant for AstraZeneca, Pfizer, Gilead and Janssen-Cilag. S. A. R. W. has attended Advisory Boards and acted as a consultant to Janssen-Cilag and AstraZeneca. C. G. has served as a consultant for Janssen-Cilag and Pfizer. J. M. has received travel and speaker fees in relation to investigator-initiated research projects from Fresenius Kabi. D. L. P. has received research grants from AstraZeneca and has attended Advisory Boards, acted as a consultant to, or given lectures with honoraria from Three Rivers Pharmaceuticals, Merck, AstraZeneca, SanofiAventis, Pfizer, Johnson & Johnson, and Leo Pharmaceuticals. J. L. has received research grants from AstraZeneca and has attended Advisory Boards, acted as a consultant to, or given lectures with honoraria from AstraZeneca, Janssen-Cilag, Merck Sharp & Dohme, Pfizer, and Wyeth Australia. All other authors report no potential conflicts.