Trial reportBritish journal of clinical pharmacology2007
Continuous vs. intermittent cefotaxime administration in patients with chronic obstructive pulmonary disease and respiratory tract infections: pharmacokinetics/pharmacodynamics, bacterial susceptibility and clinical efficacy.
Trial report in British journal of clinical pharmacology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Continuous versus intermittent infusions of antibiotics for the treatment of severe acute infections.The Cochrane database of systematic reviews · 2013Pooled it
- Does prolonged β-lactam infusions improve clinical outcomes compared to intermittent infusions? A meta-analysis and systematic review of randomized, controlled trials.BMC infectious diseases · 2011Pooled it
- Population Pharmacokinetic Model to Optimize Cefotaxime Dosing Regimen in Critically Ill Children.Clinical pharmacokinetics · 2018Trial
- Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis.Intensive care medicine · 2016Trial
- Article
- Recent Advances in Di-, Tri-Substituted Mono-Thiazoles, and Bis-Thiazoles: Factors Affecting Biological Activities, Future Aspects, and Challenges.Current topics in medicinal chemistry · 2025Review
- Rationale and Logistics of Continuous Infusion Cephalosporin Antibiotics.Pharmacy (Basel, Switzerland) · 2024Review
- Efficacy of Continuous vs. Intermittent Administration of Cefepime in Adult ICU Patients with Gram-Negative Bacilli Bacteremia: A Randomized Double-Blind Clinical Study.Antibiotics (Basel, Switzerland) · 2024Article
- Dose optimization of cefotaxime as pre-emptive treatment in critically ill adult patients: A population pharmacokinetic study.British journal of clinical pharmacology · 2023Article
- Histological Changes in Ovary Treated with Dexamethasone and Cefotaxime Sodium.Archives of Razi Institute · 2022Article
- Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study.Biomedicines · 2021Article
- Differential antibiotic dosing in critical care: survey on nurses' knowledge, perceptions and experience.JAC-antimicrobial resistance · 2020Article
- Pharmacodynamic model for β-lactam regimens used in surgical prophylaxis: model-based evaluation of standard dosing regimens.International journal of clinical pharmacy · 2018Article
- Pharmacokinetics-pharmacodynamics issues relevant for the clinical use of beta-lactam antibiotics in critically ill patients.Critical care (London, England) · 2018Review
- Continuous and Prolonged Intravenous β-Lactam Dosing: Implications for the Clinical Laboratory.Clinical microbiology reviews · 2016Review
- Pharmacokinetic/pharmacodynamic profiling of imipenem in patients admitted to an intensive care unit in India: A nonrandomized, cross-sectional, analytical, open-labeled study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2015Article
- Intraosseous and intravenous administration of antibiotics yields comparable plasma concentrations during experimental septic shock.Acta anaesthesiologica Scandinavica · 2015Article
- Continuous beta-lactam infusion in critically ill patients: the clinical evidence.Annals of intensive care · 2012Article
- Continuous infusion of antibiotics in the critically ill: The new holy grail for beta-lactams and vancomycin?Annals of intensive care · 2012Article
- Continuous versus intermittent administration of piperacillin-tazobactam in intensive care unit patients with ventilator-associated pneumonia.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo compare the pharmacokinetics/pharmacodynamics, antibiotic resistance and clinical efficacy of continuous (CA) vs. intermittent administration (IA) of cefotaxime in patients with obstructive pulmonary disease and respiratory infections.
methodsA randomized controlled prospective nonblinded study was performed in 93 consecutive hospitalized patients requiring antibiotics for acute exacerbations of chronic obstructive pulmonary disease. Forty-seven patients received 2 g of cefotaxime intravenously over 24 h plus a loading dose of 1 g, and 46 patients were given the drug intermittently (1 g three times daily).
resultsSimilar pathogens were identified in both groups, being mostly Haemophilus influenzae (51%), Streptococcus pneumoniae (21%) and Moraxella catharralis (18%). Mean minimal inhibitory concentration (MIC) values were also similar before and after treatment in both groups. Clinical cure was achieved in 37/40 (93%) (CA) vs. 40/43 (93%) (IA) of patients (P = 0.93). In microbiologically evaluable patients, criteria such as 70% of treatment time with antibiotic concentrations > or = MIC (CA 100%vs. IA 60% of patients) and/or > or = 5 x MIC (CA 100%vs. IA 55% of patients) were significantly better following continuous administration (P < 0.01). Samples with suboptimal antibiotic concentrations were found in 0% of CA vs. 65% of IA patients (P < 0.01).
conclusionsAlthough clinical cure rates were comparable, continuous cefotaxime administration led to significantly greater proportions of concentrations > MIC and > 5 x MIC compared with intermittent dosing. Continuous administration of cefotaxime at a lower dose [2 g (CA) vs. 3 g (CI)] is equally effective pharmacodynamically and microbiologically, may be more cost-effective and offers at least the same clinical efficacy. Based on these observations, we recommend continuous administration of cefotaxime as the preferred mode of administration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.