Prolonged β-Lactam Antibiotic Infusions Aid Sepsis, Septic Shock Outcomes

2024-06-14

临床结果

FRIDAY, June 14, 2024 -- Among adults in the intensive care unit with sepsis or septic shock, the use of prolonged β-lactam antibiotic infusions is associated with lower risk of 90-day mortality compared with intermittent infusions, according to research published online June 12 in the Journal of the American Medical Association to coincide with the annual Critical Care Reviews Meeting, held from June 12 to 14 in Belfast, Northern Ireland.

Mohd H. Abdul-Aziz, Ph.D., from the University of Queensland in Brisbane, Australia, and colleagues conducted a systematic literature review to determine whether prolonged β-lactam antibiotic infusions versus intermittent infusions are associated with a reduced risk of death in critically ill adults with sepsis or septic shock.

The researchers identified 18 eligible randomized clinical trials (9,108 critically ill adults). For prolonged infusions of β-lactam antibiotics, the pooled estimated risk ratio [RR] for all-cause, 90-day mortality was 0.86 (I2 = 21.5 percent; high certainty), compared with intermittent infusions. There was a 99.1 percent posterior probability that prolonged infusions were associated with lower 90-day mortality. Additionally, prolonged infusion of β-lactam antibiotics was associated with a lower risk of intensive care unit mortality (RR, 0.84; high certainty) and an increase in clinical cure (RR, 1.16; moderate certainty).

"The current evidence presents a high degree of certainty for clinicians to consider prolonged infusions as a standard of care in the management of sepsis and septic shock," the authors write.

Several authors disclosed ties to the pharmaceutical and biotechnology industries.

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