Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis

This study aims to determine if continuous infusion (CI) is associated with better clinical and pharmacokinetic/pharmacodynamic (PK/PD) outcomes compared to intermittent bolus (IB) dosing in critically ill patients with severe sepsis. This was a two-centre randomised controlled trial of CI versus I...

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Main Authors:	Abdul Aziz, Mohd. Hafiz, Sulaiman, Helmi, Mat Nor, Mohd Basri, Rai, Vineya, Wong, K., Hasan, Mohd Shahnaz, Abd. Rahman, Nurul Azrin, Jamal, Janattul-Ain, Wallis, Steven C., Lipman, Jeffrey, Staatz, Christine E., Roberts, Jason A.
Format:	Article
Language:	English English
Published:	Springer Verlag 2016
Subjects:	QR Microbiology RM Therapeutics. Pharmacology RS Pharmacy and materia medica
Online Access:	http://irep.iium.edu.my/49261/ http://irep.iium.edu.my/49261/ http://irep.iium.edu.my/49261/ http://irep.iium.edu.my/49261/6/Abdul-Aziz%20et%20al.%202016.%20Intensive%20Care%20Medicine.pdf http://irep.iium.edu.my/49261/12/49261_Beta-Lactam%20Infusion_wos.pdf

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recordtype	eprints
spelling	iium-492612017-04-04T06:25:19Z http://irep.iium.edu.my/49261/ Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis Abdul Aziz, Mohd. Hafiz Sulaiman, Helmi Mat Nor, Mohd Basri Rai, Vineya Wong, K. Hasan, Mohd Shahnaz Abd. Rahman, Nurul Azrin Jamal, Janattul-Ain Wallis, Steven C. Lipman, Jeffrey Staatz, Christine E. Roberts, Jason A. QR Microbiology RM Therapeutics. Pharmacology RS Pharmacy and materia medica This study aims to determine if continuous infusion (CI) is associated with better clinical and pharmacokinetic/pharmacodynamic (PK/PD) outcomes compared to intermittent bolus (IB) dosing in critically ill patients with severe sepsis. This was a two-centre randomised controlled trial of CI versus IB dosing of beta-lactam antibiotics, which enrolled critically ill participants with severe sepsis who were not on renal replacement therapy (RRT). The primary outcome was clinical cure at 14 days after antibiotic cessation. Secondary outcomes were PK/PD target attainment, ICU-free days and ventilator-free days at day 28 post-randomisation, 14- and 30-day survival, and time to white cell count normalisation. A total of 140 participants were enrolled with 70 participants each allocated to CI and IB dosing. CI participants had higher clinical cure rates (56 versus 34 %, p = 0.011) and higher median ventilator-free days (22 versus 14 days, p < 0.043) than IB participants. PK/PD target attainment rates were higher in the CI arm at 100 % fT >MIC than the IB arm on day 1 (97 versus 70 %, p < 0.001) and day 3 (97 versus 68 %, p < 0.001) post-randomisation. There was no difference in 14-day or 30-day survival between the treatment arms. In critically ill patients with severe sepsis not receiving RRT, CI demonstrated higher clinical cure rates and had better PK/PD target attainment compared to IB dosing of beta-lactam antibiotics. Continuous beta-lactam infusion may be mostly advantageous for critically ill patients with high levels of illness severity and not receiving RRT. Springer Verlag 2016-01-11 Article PeerReviewed application/pdf en http://irep.iium.edu.my/49261/6/Abdul-Aziz%20et%20al.%202016.%20Intensive%20Care%20Medicine.pdf application/pdf en http://irep.iium.edu.my/49261/12/49261_Beta-Lactam%20Infusion_wos.pdf Abdul Aziz, Mohd. Hafiz and Sulaiman, Helmi and Mat Nor, Mohd Basri and Rai, Vineya and Wong, K. and Hasan, Mohd Shahnaz and Abd. Rahman, Nurul Azrin and Jamal, Janattul-Ain and Wallis, Steven C. and Lipman, Jeffrey and Staatz, Christine E. and Roberts, Jason A. (2016) Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis. Intensive care medicine. pp. 1-11. ISSN 0342-4642 E-ISSN 1432-1238 http://link.springer.com/article/10.1007%2Fs00134-015-4188-0 10.1007/s00134-015-4188-0
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	QR Microbiology RM Therapeutics. Pharmacology RS Pharmacy and materia medica
spellingShingle	QR Microbiology RM Therapeutics. Pharmacology RS Pharmacy and materia medica Abdul Aziz, Mohd. Hafiz Sulaiman, Helmi Mat Nor, Mohd Basri Rai, Vineya Wong, K. Hasan, Mohd Shahnaz Abd. Rahman, Nurul Azrin Jamal, Janattul-Ain Wallis, Steven C. Lipman, Jeffrey Staatz, Christine E. Roberts, Jason A. Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
description	This study aims to determine if continuous infusion (CI) is associated with better clinical and pharmacokinetic/pharmacodynamic (PK/PD) outcomes compared to intermittent bolus (IB) dosing in critically ill patients with severe sepsis. This was a two-centre randomised controlled trial of CI versus IB dosing of beta-lactam antibiotics, which enrolled critically ill participants with severe sepsis who were not on renal replacement therapy (RRT). The primary outcome was clinical cure at 14 days after antibiotic cessation. Secondary outcomes were PK/PD target attainment, ICU-free days and ventilator-free days at day 28 post-randomisation, 14- and 30-day survival, and time to white cell count normalisation. A total of 140 participants were enrolled with 70 participants each allocated to CI and IB dosing. CI participants had higher clinical cure rates (56 versus 34 %, p = 0.011) and higher median ventilator-free days (22 versus 14 days, p < 0.043) than IB participants. PK/PD target attainment rates were higher in the CI arm at 100 % fT >MIC than the IB arm on day 1 (97 versus 70 %, p < 0.001) and day 3 (97 versus 68 %, p < 0.001) post-randomisation. There was no difference in 14-day or 30-day survival between the treatment arms. In critically ill patients with severe sepsis not receiving RRT, CI demonstrated higher clinical cure rates and had better PK/PD target attainment compared to IB dosing of beta-lactam antibiotics. Continuous beta-lactam infusion may be mostly advantageous for critically ill patients with high levels of illness severity and not receiving RRT.
format	Article
author	Abdul Aziz, Mohd. Hafiz Sulaiman, Helmi Mat Nor, Mohd Basri Rai, Vineya Wong, K. Hasan, Mohd Shahnaz Abd. Rahman, Nurul Azrin Jamal, Janattul-Ain Wallis, Steven C. Lipman, Jeffrey Staatz, Christine E. Roberts, Jason A.
author_facet	Abdul Aziz, Mohd. Hafiz Sulaiman, Helmi Mat Nor, Mohd Basri Rai, Vineya Wong, K. Hasan, Mohd Shahnaz Abd. Rahman, Nurul Azrin Jamal, Janattul-Ain Wallis, Steven C. Lipman, Jeffrey Staatz, Christine E. Roberts, Jason A.
author_sort	Abdul Aziz, Mohd. Hafiz
title	Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
title_short	Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
title_full	Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
title_fullStr	Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
title_full_unstemmed	Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
title_sort	beta-lactam infusion in severe sepsis (bliss): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis
publisher	Springer Verlag
publishDate	2016
url	http://irep.iium.edu.my/49261/ http://irep.iium.edu.my/49261/ http://irep.iium.edu.my/49261/ http://irep.iium.edu.my/49261/6/Abdul-Aziz%20et%20al.%202016.%20Intensive%20Care%20Medicine.pdf http://irep.iium.edu.my/49261/12/49261_Beta-Lactam%20Infusion_wos.pdf
first_indexed	2023-09-18T21:09:40Z
last_indexed	2023-09-18T21:09:40Z
_version_	1777411167923208192

Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis

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