Clinical Outcomes With Extended or Continuous Versus Short-term Intravenous Infusion of Carbapenems and Piperacillin/Tazobactam: A Systematic Review and Meta-analysis

医学 哌拉西林/他唑巴坦 哌拉西林 他唑巴坦 置信区间 荟萃分析 药效学 内科学 麻醉 重症监护医学 药代动力学 遗传学 生物 细菌 铜绿假单胞菌
作者
Matthew E. Falagas,Giannoula S. Tansarli,Kazuro Ikawa,Konstantinos Z. Vardakas
出处
期刊:Clinical Infectious Diseases [Oxford University Press]
卷期号:56 (2): 272-282 被引量:279
标识
DOI:10.1093/cid/cis857
摘要

We sought to study whether the better pharmacokinetic and pharmacodynamic (PK/PD) properties of carbapenems and piperacillin/tazobactam, when the duration of infusion is longer, were associated with lower mortality. PubMed and Scopus were searched for studies reporting on patients treated with extended (≥3 hours) or continuous (24 hours) versus short-term duration (20–60 minutes) infusions of carbapenems or piperacillin/tazobactam. Fourteen studies were included (1229 patients). Mortality was lower among patients receiving extended or continuous infusion of carbapenems or piperacillin/tazobactam compared to those receiving short-term (risk ratio [RR], 0.59; 95% confidence interval [CI], .41–.83). Patients with pneumonia who received extended or continuous infusion had lower mortality than those receiving short-term infusion (RR, 0.50; 95% CI, 0.26–0.96). Data for other specific infections were not available. The available evidence from mainly nonrandomized studies suggests that extended or continuous infusion of carbapenems or piperacillin/tazobactam was associated with lower mortality. Well-designed randomized controlled trials are warranted to confirm these findings before such approaches become widely used.
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