SynthesisCritical care (London, England)2013
Optimal dosing of antibiotics in critically ill patients by using continuous/extended infusions: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Continuous or extended vs intermittent infusions of beta-lactam antibiotics in ICU patients with pneumonia: a systematic review and meta-analysis of randomized controlled trials.Antimicrobial agents and chemotherapy · 2025Pooled it
- Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults.The Cochrane database of systematic reviews · 2015Pooled it
- Prolonged infusion of linezolid is associated with improved pharmacokinetic/pharmacodynamic (PK/PD) profiles in patients with external ventricular drains.European journal of clinical pharmacology · 2021Trial
- Biased computation of probability of target attainment for antimicrobial drugs.CPT: pharmacometrics & systems pharmacology · 2023Article
- Identification of outcomes reported for hospital antimicrobial stewardship interventions using a systematic review of reviews.JAC-antimicrobial resistance · 2023Review
- β-Lactam Dosing in Critical Patients: A Narrative Review of Optimal Efficacy and the Prevention of Resistance and Toxicity.Antibiotics (Basel, Switzerland) · 2022Review
- Timing of antibiotic therapy in the ICU.Critical care (London, England) · 2021Review
- The Role of PK/PD Analysis in the Development and Evaluation of Antimicrobials.Pharmaceutics · 2021Review
- Clinical and pharmacokinetic/dynamic outcomes of prolonged infusions of beta-lactam antimicrobials: An overview of systematic reviews.PloS one · 2021Article
- Profile of Enterobacteria Resistant to Beta-Lactams.Antibiotics (Basel, Switzerland) · 2020Article
- Drug Dosing Considerations in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.Pharmacy (Basel, Switzerland) · 2020Article
- Calculated initial parenteral treatment of bacterial infections: Pharmacokinetics and pharmacodynamics.GMS infectious diseases · 2020Article
- Calculated initial parenteral treatment of bacterial infections: Sepsis.GMS infectious diseases · 2020Article
- Overcoming stability challenges during continuous intravenous administration of high-dose amoxicillin using portable elastomeric pumps.PloS one · 2019Article
- [Therapeutic drug monitoring and individual dosing of antibiotics during sepsis : Modern or just "trendy"?]Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2018Review
- Prolonged versus Intermittent Infusion of β-Lactams for the Treatment of Nosocomial Pneumonia: A Meta-Analysis.Infection & chemotherapy · 2016Article
- Is there a role for continuous infusion of β-lactam antibiotics in severe sepsis?Journal of thoracic disease · 2016Article
- Empiric antimicrobial therapy in severe sepsis and septic shock: optimizing pathogen clearance.Current infectious disease reports · 2015Article
- Pharmacokinetic considerations and dosing strategies of antibiotics in the critically ill patient.Journal of the Intensive Care Society · 2015Article
- Should Prolonged Infusion of β-Lactams Become Standard of Practice?The Canadian journal of hospital pharmacyArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
introductionThe aim of this study was to determine whether using pharmacodynamic-based dosing of antimicrobials, such as extended/continuous infusions, in critically ill patients is associated with improved outcomes as compared with traditional dosing methods.
methodsWe searched Medline, HealthStar, EMBASE, Cochrane Clinical Trial Registry, and CINAHL from inception to September 2013 without language restrictions for studies comparing the use of extended/continuous infusions with traditional dosing. Two authors independently selected studies, extracted data on methodology and outcomes, and performed quality assessment. Meta-analyses were performed by using random-effects models.
resultsOf 1,319 citations, 13 randomized controlled trials (RCTs) (n = 782 patients) and 13 cohort studies (n = 2,117 patients) met the inclusion criteria. Compared with traditional non-pharmacodynamic-based dosing, RCTs of continuous/extended infusions significantly reduced clinical failure rates (relative risk (RR) 0.68; 95% confidence interval (CI) 0.49 to 0.94, P = 0.02) and intensive care unit length of stay (mean difference, -1.5; 95% CI, -2.8 to -0.2 days, P = 0.02), but not mortality (RR, 0.87; 95% CI, 0.64 to 1.19; P = 0.38). No significant between-trial heterogeneity was found for these analyses (I2 = 0). Reduced mortality rates almost achieved statistical significance when the results of all included studies (RCTs and cohort studies) were pooled (RR, 0.83; 95% CI, 0.69 to 1.00; P = 0.054).
conclusionsPooled results from small RCTs suggest reduced clinical failure rates and intensive care unit length-of-stay when using continuous/extended infusions of antibiotics in critically ill patients. Reduced mortality rates almost achieved statistical significance when the results of RCTs were combined with cohort studies. These results support the conduct of adequately powered RCTs to define better the utility of continuous/extended infusions in the era of antibiotic resistance.
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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.