Extended or continuous versus short-term intravenous infusion of cephalosporins: a meta-analysis

Abstract

The authors sought to study whether extended or continuous infusion of cephalosporins is associated with better clinical outcomes than short-term infusion. PubMed and Scopus databases were systematically searched. Studies reporting the clinical outcomes of patients receiving extended or continuous infusion (≥3 or 24 h, respectively) versus short-term infusion (≤1 h) of cephalosporins were considered eligible. Eleven studies (1250 clinically evaluable patients) were included. Clinical cure and mortality were not statistically different between the compared groups (risk ratio: 1.14; 95% CI: 0.94–1.37 and risk ratio: 0.96; 95% CI: 0.80–1.15, respectively). This meta-analysis did not show a difference in clinical cure or mortality regarding extended or continuous versus short-term intravenous infusion of cephalosporins. However, in most of the included studies, patients in the extended/continuous infusion group received a substantially lower total dosage of antibiotic than those in the short-term group for the total duration of treatment.

Keywords::

• bolus administration
• cefepime
• cefoperazone
• cefotaxime
• ceftazidime
• ceftriaxone
• intermittent infusion
• prolonged infusion

Financial & competing interests disclosure

ME Falagas participated in advisory boards of Achaogen, Astellas, AstraZeneca, Bayer and Pfizer; received lecture honoraria from Angelini, Astellas, AstraZeneca, Glenmark, Merck and Novartis; and received research support from Angelini, Astellas and Rokitan. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.