Continuous vs intermittent β-lactam antibiotic infusions in critically ill patients with sepsis

About The Study: The observed difference in 90-day mortality between continuous versus intermittent infusions of β-lactam antibiotics did not meet statistical significance in the primary analysis. However, the confidence interval around the effect estimate includes the possibility of both no important effect and a clinically important benefit in the use of continuous infusions in this group of patients.

Quote from corresponding author Joel M. Dulhunty, M.D., Ph.D.:

“The BLING III trial provides important evidence to guide antibiotic management and improve outcomes for patients with sepsis. This large randomized clinical trial involved over 7,000 patients with sepsis and compared continuous and short intermittent infusions for two common beta-lactam antibiotics. We found mortality at 90 days was 2% lower and clinical cure was 6% higher in patients receiving continuous infusions.

“While the difference in survival was not statistically significant, we conclude that these findings represent a likely clinically important benefit with the use of continuous infusions in adult patients treated for sepsis in the intensive care unit with piperacillin-tazobactam or meropenem.”

Contact information for Joel M. Dulhunty, M.D., Ph.D.: email Joel.Dulhunty@health.qld.gov.au.

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(doi:10.1001/jama.2024.9779)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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Media advisory: This study is being presented at the Critical Care Reviews Meeting 2024.

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