| Title |
Continuous Infusion Versus Intermittent Bolus of Beta-Lactams in Critically Ill Patients with Respiratory Infections: A Systematic Review and Meta-analysis
|
|---|---|
| Published in |
European Journal of Drug Metabolism and Pharmacokinetics, October 2017
|
| DOI | 10.1007/s13318-017-0439-5 |
| Pubmed ID | |
| Authors |
Young R. Lee, Pamela D. Miller, Saeed K. Alzghari, Delilah D. Blanco, Jackson D. Hager, Kailey S. Kuntz |
| Abstract |
Critically ill patients display altered pharmacokinetics and pharmacodynamics and are more likely to be infected with more resistant pathogens. Beta-lactam antibiotics exhibit time-dependent pharmacodynamics; therefore, it is postulated that continuous infusion (CI) may optimize these parameters. To perform a systematic review and meta-analysis of the available literature comparing CI versus intermittent bolus (IB) of beta-lactam antibiotics in critically ill adult patients with respiratory infections to determine if clinical benefits exist. PubMed, EMBASE, and Web of Science were searched. Thirteen randomized controlled trials were included in the meta-analyses of clinical cure and/or mortality. Four retrospective studies reporting clinical cure and/or mortality, and 11 studies that reported pharmacokinetic/pharmacodynamic parameters were included in the systematic review. The majority of patients in both groups maintained the percentage of time the free drug concentration exceeded the minimum inhibitory concentration (%fT > MIC) targets throughout the treatment, with differences favoring CI being more prevalent when the MIC of the offending pathogen increased. CI of beta-lactam antibiotics in critically ill adult patients with respiratory infections significantly improved clinical cure rates when compared to IB (risk ratio [RR] 1.177; 95% CI 1.065-1.300). No significant differences in mortality rates were seen when patients were treated with either dosing modality (RR 0.845; 95% CI 0.644-1.108). CI of beta-lactam antibiotics is associated with better cure rates and higher %fT > MIC when administered to critically ill patients with respiratory infections, but may be most beneficial in severely ill patients with more resistant Gram-negative bacterial infections. |
X Demographics
The data shown below were collected from the profiles of 15 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Saudi Arabia | 6 | 40% |
| Kuwait | 2 | 13% |
| United Kingdom | 1 | 7% |
| Spain | 1 | 7% |
| Unknown | 5 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 13 | 87% |
| Practitioners (doctors, other healthcare professionals) | 2 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 65 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 9 | 14% |
| Researcher | 9 | 14% |
| Student > Bachelor | 8 | 12% |
| Student > Master | 8 | 12% |
| Student > Postgraduate | 7 | 11% |
| Other | 13 | 20% |
| Unknown | 11 | 17% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 34% |
| Pharmacology, Toxicology and Pharmaceutical Science | 16 | 25% |
| Agricultural and Biological Sciences | 3 | 5% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Business, Management and Accounting | 1 | 2% |
| Other | 4 | 6% |
| Unknown | 18 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 September 2018.
All research outputs
#3,300,229
of 25,728,855 outputs
Outputs from European Journal of Drug Metabolism and Pharmacokinetics
#22
of 469 outputs
Outputs of similar age
#58,559
of 335,099 outputs
Outputs of similar age from European Journal of Drug Metabolism and Pharmacokinetics
#1
of 6 outputs
Altmetric has tracked 25,728,855 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 469 research outputs from this source. They receive a mean Attention Score of 3.6. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 335,099 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 6 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them