caa a22 4500 397592876 CHVBK 20180308164943.0 cr unu---uuuuu 161202e199607 xx s 000 0 eng 10.1093/jac/38.1.5 doi (NATIONALLICENCE)oxford-10.1093/jac/38.1.5 Is continuous infusion of β-lactam antibiotics worthwhile?—efficacy and pharmacokinetic considerations [Elektronische Daten] [Johan W. Mounton, Alexander A. T. M. M. Vinks] The most important pharmacodynamic parameter for β-lactam antibiotics has been shown to be the time above the MIC, which is used as an argument to administer β-lactam antibiotics by continuous infusion. Studies in vitro and in laboratory animals comparing efficacy of continuous and intermittent infusion of β-lactam antibiotics generally show continuous infusion to be more efficacious. While comparative trials in humans are scarce and a significant difference was only found in subgroup analysis in one study, several case-reports support the use of continuous infusion. Arguments in favour and against continuous infusion are discussed. Although dose-ranging studies have not yet been performed in humans, the results from in-vitro and in-vivo experiments indicate that 4 × MIC for the infecting bacterium would be the target concentration. Pharmacokinetic studies which have been performed in humans during continuous infusion show that serum concentrations can be predicted from total clearance or, using population pharmacokinetic modelling, the elimination rate constant as obtained during intermittent infusion. A nomogram is presented which allows calculation of the daily dose to obtain the target steady state blood concentrations suggested by the susceptibility of the infecting bacterium, usually 4 × MIC. For bacteria with a low MIC, the daily dose may be substantially lower than that used in conventional dosing regimens, while in infections which are difficult to treat as a result of more resistant bacteria, continuous infusion may be more effective than an equivalent bolus dose. © 1996 by the British Society for Antimicrobial Chemotherapy Review nationallicence Mounton Johan W. Department of Clinical Microbiology, Erasmus University Hospital Rotterdam dr molewaterplein 40, 3015 gd Rotterdam aut Vinks Alexander A. T. M. M. The Hague Hospitals Central Pharmacy The Hague, The Netherlands aut Journal of Antimicrobial Chemotherapy Oxford University Press 38/1(1996-07), 5-15 0305-7453 38:1<5 1996 38 jac https://doi.org/10.1093/jac/38.1.5 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jac/38.1.5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mounton Johan W. Department of Clinical Microbiology, Erasmus University Hospital Rotterdam dr molewaterplein 40, 3015 gd Rotterdam aut NATIONALLICENCE 700 1- Vinks Alexander A. T. M. M. The Hague Hospitals Central Pharmacy The Hague, The Netherlands aut NATIONALLICENCE 773 0- Journal of Antimicrobial Chemotherapy Oxford University Press 38/1(1996-07), 5-15 0305-7453 38:1<5 1996 38 jac Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford