Continuous infusion of antimicrobial agents has been studied since the 1950s. Penicillin was the first antibiotic studied using this method of administration. Investigators noted that it was most effective when serum concentrations at the site of infection remained above those that were necessary to kill the bacteria. In order to achieve maximal efficacy, penicillin had to be administered by continuous infusion or at 2-4 hour intervals. This early observation provided a basis for the concept of time-dependant killing. More recently, studies have provided evidence that the time-dependant activity of beta-lactam antibiotics is dependent on the percentage of time above the bacteria’s MIC and correlates well with therapeutic efficacy (1). Greater killing is not achieved with beta-lactam antibiotics once the MIC is exceeded by 4-5 times. The results of clinical trials have established the minimum percent time above the MIC for many beta-lactam agents. Optimal efficacy of penicillins, cephalosporins, and carbapenems is achieved when serum concentrations remain above the MIC for ≥ 50%, 50-60%, and 20-40% of the dosing interval, respectively (2-4).
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Why do antibiotics need to be infused for so long?
Jun 30, 2016 · The prolonged infusion of time-dependent antibiotics maximizes the achievement of relevant therapeutic concentrations over time (i.e.PK) and enables the maximum action of the drug (i.e.PD). The PK/PD of antimicrobials are the foundation of drug dose establishment, which is aimed at optimizing the clinical outcomes [3].
Is continuous infusion of antimicrobial agents effective?
Jul 02, 2012 · The alarming global rise of antimicrobial resistance combined with the lack of new antimicrobial agents has led to a renewed interest in optimization of our current antibiotics. Continuous infusion (CI) of time-dependent antibiotics has certain theoretical advantages toward efficacy based on pharmacokinetic/pharmacodynamic principles.
Why do we use prolonged perfusion for antibiotic administration?
Mar 16, 2021 · Continuous infusion of antibiotics using elastomeric pumps in the hospital at home setting ... Depending on the location of the infection, the duration of treatment is detailed in Table 3. Osteomyelitis required a longer period of antibiotic treatment, with a mean of 24.87 ± 17.19 days of treatment, followed by skin and soft tissue infections ...
Is continuous infusion of beta-lactam antibiotics effective in the treatment of sepsis?
inhibitory concentration (MIC) for a given amount of time over the dosing interval. Continuous infusion is a method of administration that allows for consistent steady state concentrations and maximizes the percent of time above an organism’s MIC. Continuous infusion is an alternative to intermittent infusion. It
Why is a continuous antibiotic infusion effective?
The prolonged infusion of time-dependent antibiotics maximizes the achievement of relevant therapeutic concentrations over time (i.e. PK) and enables the maximum action of the drug (i.e. PD).Jun 30, 2016
How do bacteriostatic antibiotics which only inhibit bacterial growth contribute to the elimination of infection?
Often called bacteriostatic antibiotics, they prevent nutrients from reaching the bacteria, which stops them from dividing and multiplying. Because millions of bacteria are needed to continue the disease process, these antibiotics can stop the infection and give the body's own immune system time to attack.Nov 15, 2019
What antibiotic can be given as a 24 hour infusion?
Not all beta-lactam antibiotics are stable enough for a 24-h infusion. Piperacillin [59], temocillin [13], and aztreonam [59,60] are stable at room temperature for at least 24 h. Ceftazidime and cefepime are stable for 24 h at 25°C, but only for 8 h and 13 h, respectively, at 37°C [59,61,62].
Why are bacteriostatic antibiotics effective?
Bacteriostatic = antibiotics that inhibit the growth of bacteria (i.e. prevent the bacteria from continuing to grow/proliferate) without killing bacteria in vitro OR it is able to kill the bacteria in vitro but at a slower rate than bactericidal agent does.Feb 16, 2018
Why is bacteriostatic better than bactericidal?
Bacteriostatic treatments differ from bactericidal versions in that they inhibit the growth and multiplications of bacterial cells, rather than directly kill them. Bacteriostatic agents can achieve this by obstructing the metabolic mechanisms of the bacterial cell, in most cases targeting the protein synthesis.Jul 4, 2019
What does continuous infusion mean?
Listen to pronunciation. (kon-TIN-yoo-us in-FYOO-zhun) The administration of a fluid into a blood vessel, usually over a prolonged period of time.
What is a prolonged infusion?
Prolonged infusion administration strategies for intravenous beta-lactam antibiotics may include either a continuous infusion (over the entire dosing interval) or an extended infusion (over 2 to 4 hours) as opposed to traditional, intermittent infusion times (over 30 to 60 minutes).Jun 23, 2021
Why are beta-lactam antibiotics administered prolonged infusions in critically ill patients?
We suggest administering beta-lactam antibiotics by prolonged or continuous infusions for infections due to bacteria with high MIC in order to increase the probability of achieving the PK-PD targets.Mar 29, 2019