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KMID : 1144320160480020081
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감염과 화학요법
2016 Volume.48 No. 2 p.81 ~ p.90
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Prolonged versus Intermittent Infusion of β-Lactams for the Treatment of Nosocomial Pneumonia: A Meta-Analysis
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Lal Ashima
Jaoude Philippe
El-Solh Ali-A.
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Abstract
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Background: The primary objective of this meta-analysis is aimed at determining whether β-lactams prolonged infusion in patients with nosocomial pneumonia (NP) results in higher cure rate and improved mortality compared to intermittent infusion.
Materials and Methods: Relevant studies were identified from searches of MEDLINE, EMBASE, and CENTRAL from inception to September 1st, 2015. All published articles which evaluated the outcome of extended/continuous infusion of antimicrobial therapy versus intermittent infusion therapy in the treatment of NP were reviewed.
Results: A total of ten studies were included in the analysis involving 1,051 cases of NP. Prolonged infusion of β-lactams was associated with higher clinical cure rate (OR 2.45, 95% CI, 1.12, 5.37) compared to intermittent infusion. However, there was no significant difference in mortality (OR 0.85, 95% CI 0.63?1.15) between the two groups. Subgroup analysis for β-lactam subclasses and for severity of illness showed comparable outcomes.
Conclusion: The limited data available suggest that reduced clinical failure rates when using prolonged infusions of β-lactam antibiotics in critically ill patients with NP. More detailed studies are needed to determine the impact of such strategy on mortality in this patient population.
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KEYWORD
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Prolonged infusion, β-lactams, Clinical cure, Mortality
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