Sepsis & infection

Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

JAMAPublished Systematic review and meta-analysis of randomised trials

Pooled result · All-cause 90-day mortalityResult — go to the resultRelative risk 0.86 95% CrI 0.72–0.98

Authors' conclusion

Among adults in the intensive care unit who had sepsis or septic shock, the use of prolonged β-lactam antibiotic infusions was associated with a reduced risk of 90-day mortality compared with intermittent infusions.

Study context

Population
Critically ill adults with sepsis or septic shock
Participants
9,108 adults · 18 RCTs
Comparison
Prolonged vs intermittent infusions of β-lactam antibiotics
Outcome
All-cause 90-day mortality
Follow-up
90 days
Methodological detailsbayesian primary analysis, frequentist secondary analysis, GRADE certainty assessment
  • Bayesian primary analysis
  • Frequentist secondary analysis
  • GRADE certainty assessment

Pooled result

As reported in the abstract

Relative risk

0.86

95% CrI 0.72–0.98

Prolonged infusions vs Intermittent infusions
RR 0.86 (95% CrI 0.72–0.98)
Posterior probability that prolonged infusions associated with lower 90-day mortality
99.1%

Further pooled results

OutcomeRR (95% CrI)
ICU mortalityHigh certainty0.84 (0.70–0.97)
Clinical cureModerate certainty1.16 (1.07–1.31)
  • Intensive care unit (ICU) mortality: 95% CrI
  • Clinical cure: 95% CrI

Original publication

Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock: A Systematic Review and Meta-Analysis. JAMA. Published 27 August 2024. doi:10.1001/jama.2024.9803

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