- This meta-analysis suggests that continuous/prolonged infusion (C/PI) of piperacillin-tazobactam in critically ill adult patients is associated with improved clinical cure, mortality, and length of hospital stay in comparison to the intermittent infusion (II).
Why this matters
- Findings warrant more rigorous scientific studies to reach a sufficient level of evidence and promote further implementation of C/PI as a dosing strategy in critically ill patients.
- Meta-analysis of 23 studies including 3828 critically ill adult patients (C/PI, n=2197 and II, n=1631).
- Funding: None disclosed.
- C/PI vs II group had significantly higher clinical cure (OR, 1.56; 95% CI, 1.28-1.90; P=.0001) and microbiological success rates (OR, 1.52; 95% CI, 1.10-2.11; P=.01).
- Mortality rates were lower in patients receiving C/PI compared with patients receiving conventional II (OR, 0.68; 95% CI, 0.55-0.84; P=.0003).
- Patients receiving C/PI vs those receiving II had a significantly shorter length of hospital stay (mean difference, -1.27; 95% CI, -2.45 to -0.08; P=.04; I2, 65%)
- No significant difference was observed in adverse events between the two infusion strategies (OR, 0.85; 95%CI, 0.50-1.42; P=.53).
- It is unclear which of the two dosing strategies is most effective as prolonged infusion and continuous infusion were combined and referred to as C/PI.
- Risk of bias.