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Pharmacotherapy Publishes International Consensus Recommendations for the Use of Prolonged-Infusion β-Lactams

Published on: Oct 17, 2023

The first international consensus recommendations for the use of prolonged-infusion β-lactams have been reviewed and endorsed by the American College of Clinical Pharmacy, British Society for Antimicrobial Chemotherapy, Cystic Fibrosis Foundation, European Society of Clinical Microbiology and Infectious Diseases, Infectious Diseases Society of America, Society of Critical Care Medicine, and Society of Infectious Diseases Pharmacists.

Intravenous β-lactam antibiotics remain a cornerstone in the management of bacterial infections because of their broad spectrum of activity and excellent tolerability. Prolonged (extended and continuous) infusion of β-lactam antibiotics can increase the time above the minimum inhibitory concentration of the pathogen to optimize the reduction in bacterial burden. To date, however, implementation of prolonged-infusion dosing regimens has been inconsistent. An international, multidisciplinary panel of experts in infectious diseases and clinical pharmacology, led by ACCP members Lisa Hong and Marc Scheetz, reviewed the published literature to formulate consensus recommendations for the use of prolonged-infusion β-lactam antibiotics.

The consensus recommendations provide guidance regarding pharmacokinetic and pharmacodynamic targets, therapeutic drug monitoring, and use of prolonged-infusion β-lactam therapy in severely and non-severely ill adult patients, pediatric patients, and patients with obesity. The Consensus Recommendations and Executive Summary are published open access in the August 2023 issue of Pharmacotherapy, an official journal of ACCP.

Pharmacotherapy editor-in-chief, Dr. C. Lindsay DeVane, commented:

The tenets of drug dosage regimen design are perhaps more important for antimicrobial use than in many areas of pharmacotherapy. The ability to establish pharmacodynamic goals including minimum inhibitory concentrations allows pharmacokinetic principles theorized and confirmed over several decades to be applied in individual patients to optimize drug efficacy. The availability of consensus recommendations endorsed by international organizations for prolonged infusion of β-lactam antibiotics provides an impetus to improve the effective treatment of infectious diseases using currently available resources.