Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial
Authors' conclusion
The observed difference in 90-day mortality between continuous vs intermittent infusions of β-lactam antibiotics did not meet statistical significance in the primary analysis.
Study context
- Population
- Critically ill adults (≥18 years) treated with piperacillin-tazobactam or meropenem for sepsis, 104 intensive care units (ICUs) in Australia, Belgium, France, Malaysia, New Zealand, Sweden, UK7,031 in primary analysis
- Participants
- 7,202 adults
- Comparison
- Continuous vs intermittent infusion of a β-lactam antibiotic
- Continuousn = 3,498
- Intermittentn = 3,533reference
- Primary endpoint
- All-cause mortality
- Follow-up
- 90 days after randomization
Methodological detailsinternational, open-label, multicentre (104 ICUs), Recruitment March 26, 2018, to January 11, 2023; follow-up completed April 12, 2023
- International
- Open-label
- Multicentre (104 ICUs)
- Recruitment March 26, 2018, to January 11, 2023; follow-up completed April 12, 2023
Primary result
As reported in the abstract
90 days
Each group vs intermittentAbsolute difference, % (95% CI)
Continuous
−1.9(−4.9% to 1.1%)
Each group vs intermittentOdds ratio (95% CI)P value
Continuous
0.91(0.81–1.01)
P = 0.08Secondary outcomes
| Outcome | Continuous | Intermittent | Absolute difference (%) (95% CI) | |
|---|---|---|---|---|
| Clinical cure · up to 14 days | 55.7% | 50.0% | 5.7 (2.4%–9.1%) | |
| −50510Difference, % (linear scale) |
Multiresistant organism or C difficile infection, ICU mortality, in-hospital mortality
- Not statistically different
Original publication
Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial. JAMA. Published 27 August 2024. doi:10.
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