Skip to main content

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

Â