THE EFFECTS OF PROLONGED INFUSION OF BETA-LACTAM ANTIBIOTICS ON SEPSIS: A LITERATURE REVIEW (Atena Editora)

Abstract

Antibiotics are among the most used drugs in the context of critically ill patients, which is the case of septic patients, and the beta-lactam class is one of the most prescribed in these cases. In sepsis, there are protocols that must be followed, among them is the administration of broad-spectrum antimicrobials in the first three hours of diagnosis, as this measure is closely linked to the reduction of mortality in these patients. However, there are other factors that need to be taken into account and better analyzed in an attempt to also contribute to a positive outcome, such as the evaluation of the pharmacokinetics of these medications. Beta-lactams correlate their efficacy with time, that is, a better action is obtained when the serum concentration remains above the minimum inhibitory concentration of the pathogen for a longer period. In this perspective, the strategy of prolonged infusion of β-lactams has emerged as the standard treatment for sepsis or septic shock, despite its unknown efficacy. This study aimed to assess the efficacy of prolonged versus intermittent infusion of β-lactam antibiotics on outcomes in patients with sepsis or septic shock through a review using scientific databases. Prolonged infusion of β-lactam antibiotics significantly improved in achieving target plasma concentration and clinical cure without increasing the adverse event or the occurrence of antibiotic resistant bacteria. Prolonged infusion cannot improve hospital mortality, although an improvement has been demonstrated for studies published in or after 2015. More studies are needed, as suggested by a sequential analysis of trials.