Kooda Kirstin J, Nelson Julia, Ausman Sara E, Rivera Christina G, Abu Saleh Omar M, Rule Andrew D, Stevens Ryan W, Warfield Micaela N, Zhao Yanjun, Barreto Erin F
Department of Pharmacy, Mayo Clinic, Rochester, MN.
University of Arizona College of Pharmacy, Tucson, AZ.
Crit Care Explor. 2025 Aug 4;7(8):e1299. doi: 10.1097/CCE.0000000000001299. eCollection 2025 Aug 1.
This study aimed to determine if extended infusion (EI; over > 3 hr) beta-lactam therapy increased IV access requirements compared with traditional dosing (TD; over 30 min). Eighty-six adult ICU patients treated with TD anti-pseudomonal beta-lactams who underwent therapeutic drug monitoring (TDM) were included. Patients who transitioned from TD to EI after TDM (EI group) were matched 1:1 to patients who remained on TD. In the primary analysis, the median (interquartile range) total number of lumens in the 24 hours before TDM compared with the 48 hours after TDM were similar between groups (pre: TD 3 [2-5] vs. EI 4 [3-5]; p = 0.22 and post: TD 3 [2-4] vs. EI 4 [3-5]; p = 0.05). Delivery of beta-lactams via EI was not associated with a need for more IV access. Practical challenges such as access should not limit use of EI beta-lactams when indicated.
本研究旨在确定与传统给药方式（TD；30分钟以上）相比，延长输注（EI；超过3小时）β-内酰胺类药物治疗是否会增加静脉通路需求。纳入了86例接受TD抗假单胞菌β-内酰胺类药物治疗并进行治疗药物监测（TDM）的成年ICU患者。在TDM后从TD转换为EI的患者（EI组）与继续接受TD治疗的患者按1:1进行匹配。在主要分析中，TDM前24小时与TDM后48小时的管腔总数中位数（四分位间距）在两组之间相似（TDM前：TD组3[2-5] vs. EI组4[3-5]；p = 0.22；TDM后：TD组3[2-4] vs. EI组4[3-5]；p = 0.05）。通过EI方式输注β-内酰胺类药物与更多静脉通路需求无关。当有指征时，诸如通路等实际挑战不应限制EIβ-内酰胺类药物的使用。
