Alawyia Basil, Fathima Sarah, Spernovasilis Nikolaos, Alon-Ellenbogen Danny
MD, Department of Basic and Clinical Sciences, University of Nicosia Medical School, 2417 Nicosia, Cyprus.
BSc, MD, MPH, PhD, Department of Infectious Diseases, German Oncology Center, 4108 Limassol, Cyprus.
Germs. 2024 Jun 30;14(2):162-178. doi: 10.18683/germs.2024.1428. eCollection 2024 Jun.
Antimicrobial resistance (AMR) is among the greatest threats to global healthcare. The World Health Organization (WHO) estimates that by 2050 ten million deaths will be attributed to AMR annually. In response, the WHO has implemented antibiotic stewardship programs which focus on optimizing antibiotic use and raise, amongst others, the issue of the preferred method of intravenous antibiotic administration. Various studies have attempted to answer this question with conflicting results.
This review examined several studies assessing extended/continuous infusion compared to intermittent infusion of three beta-lactams: piperacillin-tazobactam, cefepime, and meropenem. The findings and conclusions of each study were summarized and compared to one another to provide a general overview of the current evidence.
We conclude that continuous/extended infusion showed a greater clinical benefit in highly critical cases, namely sepsis and febrile neutropenia, compared to intermittent infusion. Additionally, in cases where a pathogen was identified, continuous/extended infusion showed superiority. Nonetheless, high-quality studies with larger samples are needed to demonstrate the difference between these two modes of infusion in a way that would better inform guidelines and policies, aiding in the fight against AMR.
抗菌药物耐药性（AMR）是全球医疗保健面临的最大威胁之一。世界卫生组织（WHO）估计，到2050年，每年将有1000万人死于AMR。作为应对措施，WHO实施了抗生素管理计划，该计划侧重于优化抗生素使用，并提出了静脉注射抗生素的首选给药方法等问题。各种研究试图回答这个问题，但结果相互矛盾。
本综述研究了几项评估三种β-内酰胺类药物（哌拉西林-他唑巴坦、头孢吡肟和美罗培南）持续/延长输注与间歇输注效果的研究。总结了每项研究的结果和结论，并相互比较，以提供当前证据的总体概述。
我们得出结论，与间歇输注相比，持续/延长输注在脓毒症和发热性中性粒细胞减少症等高危病例中显示出更大的临床益处。此外，在确定病原体的病例中，持续/延长输注显示出优势。尽管如此，仍需要高质量的大样本研究，以更好地证明这两种输注方式之间的差异，为指南和政策提供依据，助力抗击AMR。
