Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/113165
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dc.contributor.authorDulhunty, J.-
dc.contributor.authorRoberts, J.-
dc.contributor.authorDavis, J.-
dc.contributor.authorWebb, S.-
dc.contributor.authorBellomo, R.-
dc.contributor.authorGomersall, C.-
dc.contributor.authorShirwadkar, C.-
dc.contributor.authorEastwood, G.-
dc.contributor.authorMyburgh, J.-
dc.contributor.authorPaterson, D.-
dc.contributor.authorStarr, T.-
dc.contributor.authorPaul, S.-
dc.contributor.authorLipman, J.-
dc.contributor.authorPeck, L.-
dc.contributor.authorYoung, H.-
dc.contributor.authorBoschert, C.-
dc.contributor.authorFletcher, J.-
dc.contributor.authorSmith, J.-
dc.contributor.authorNand, K.-
dc.contributor.authorSara, T.-
dc.contributor.authoret al.-
dc.date.issued2015-
dc.identifier.citationAmerican Journal of Respiratory and Critical Care Medicine, 2015; 192(11):1298-1305-
dc.identifier.issn1073-449X-
dc.identifier.issn1535-4970-
dc.identifier.urihttp://hdl.handle.net/2440/113165-
dc.description.abstractRationale: Continuous infusion of β-lactam antibiotics may improve outcomes because of time-dependent antibacterial activity compared with intermittent dosing. Objectives: To evaluate the efficacy of continuous versus intermittent infusion in patients with severe sepsis. Methods: We conducted a randomized controlled trial in 25 intensive care units (ICUs). Participants commenced on piperacillin–tazobactam, ticarcillin–clavulanate, or meropenem were randomized to receive the prescribed antibiotic via continuous or 30-minute intermittent infusion for the remainder of the treatment course or until ICU discharge. The primary outcome was the number of alive ICU-free days at Day 28. Secondary outcomes were 90-day survival, clinical cure 14 days post antibiotic cessation, alive organ failure–free days at Day 14, and duration of bacteremia. Measurements and Main Results: We enrolled 432 eligible participants with a median age of 64 years and an Acute Physiology and Chronic Health Evaluation II score of 20. There was no difference in ICU-free days: 18 days (interquartile range, 2–24) and 20 days (interquartile range, 3–24) in the continuous and intermittent groups (P = 0.38). There was no difference in 90-day survival: 74.3% (156 of 210) and 72.5% (158 of 218); hazard ratio, 0.91 (95% confidence interval, 0.63–1.31; P = 0.61). Clinical cure was 52.4% (111 of 212) and 49.5% (109 of 220); odds ratio, 1.12 (95% confidence interval, 0.77–1.63; P = 0.56). There was no difference in organ failure–free days (6 d; P = 0.27) and duration of bacteremia (0 d; P = 0.24). Conclusions: In critically ill patients with severe sepsis, there was no difference in outcomes between β-lactam antibiotic administration by continuous and intermittent infusion.-
dc.description.statementofresponsibilityJoel M. Dulhunty, Jason A. Roberts, Joshua S. Davis, Steven A. R. Webb, Rinaldo Bellomo ... Milind Sanap ... et al.-
dc.language.isoen-
dc.publisherATS Journals-
dc.rights© 2015 by the American Thoracic Society-
dc.subjectBLING II Investigators for the ANZICS Clinical Trials Group *-
dc.subjectHumans-
dc.subjectSepsis-
dc.subjectbeta-Lactams-
dc.subjectAnti-Bacterial Agents-
dc.subjectTreatment Outcome-
dc.subjectLength of Stay-
dc.subjectInfusions, Intravenous-
dc.subjectDrug Administration Schedule-
dc.subjectSurvival Analysis-
dc.subjectProspective Studies-
dc.subjectDouble-Blind Method-
dc.subjectAged-
dc.subjectMiddle Aged-
dc.subjectFemale-
dc.subjectMale-
dc.titleA multicenter randomized trial of continuous versus intermittent β-lactam infusion in severe sepsis-
dc.title.alternativeA multicenter randomized trial of continuous versus intermittent beta-lactam infusion in severe sepsis-
dc.typeJournal article-
dc.identifier.doi10.1164/rccm.201505-0857OC-
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1013411-
pubs.publication-statusPublished-
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