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Table 1 Possible advantages and disadvantages of employing continuous or intermittent administration of beta-lactam antibiotics

From: Continuous beta-lactam infusion in critically ill patients: the clinical evidence

Administration method Advantages Disadvantages
Continuous infusion More predictable antibiotic PK profiles Relatively new antibiotic administration method thus requiring intensive educational effort to update clinical staff on the administration method prior to implementation
  Lower antibiotic daily dose may be appropriate with continuous infusion Requires special infusion pumps and infusion bags that are costly
  Reduced drug acquisition costs when lower antibiotic doses are used Some beta-lactams (e.g., meropenem) are not stable under prolonged exposure at room temperature and may produce and enhance degradation products that cause hypersensitivity reactions
  Effective resource consumption (e.g., reduce the time required for pharmacists or nurses to prepare and administer antibiotic) Risk of drug wastage is high with this approach (e.g., when treatment ceased before infusion bag completed)
Intermittent bolus Simple PK/PD targets may not be achieved (especially in critically ill patients)
  Does not require dedicated line access for drug administration (incompatibility issues unlikely) Neurological adverse effects are theoretically more possible with high Cmax
  Less likely to have unexpected device failures and dosing delivery rate errors