Document Detail


Clinical outcomes with extended or continuous versus short-term intravenous infusion of carbapenems and piperacillin/tazobactam: a systematic review and meta-analysis.
MedLine Citation:
PMID:  23074314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Matthew E Falagas; Giannoula S Tansarli; Kazuro Ikawa; Konstantinos Z Vardakas
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2012-10-16
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  56     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-20     Completed Date:  2013-06-10     Revised Date:  2013-08-16    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  272-82     Citation Subset:  IM    
Affiliation:
Alfa Institute of Biomedical Sciences, Greece. m.falagas@aibs.gr
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / administration & dosage*,  adverse effects
Bacterial Infections / drug therapy*,  mortality
Carbapenems / administration & dosage*,  adverse effects
Drug Administration Schedule
Humans
Infusions, Intravenous
Penicillanic Acid / administration & dosage,  adverse effects,  analogs & derivatives*
Piperacillin / administration & dosage*,  adverse effects
Treatment Outcome
beta-Lactam Resistance
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Carbapenems; 61477-96-1/Piperacillin; 87-53-6/Penicillanic Acid; SE10G96M8W/tazobactam
Comments/Corrections
Comment In:
Clin Infect Dis. 2013 Jul;57(2):323   [PMID:  23547168 ]
Clin Infect Dis. 2013 Jul;57(2):325-7   [PMID:  23547167 ]
Clin Infect Dis. 2013 Jul;57(2):324-5   [PMID:  23547169 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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