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Extended infusion.
Extended infusion of meropenem (over 3 4 h) has been shown to improve microbiologic and clinical cure since it shows a time-dependent effect on bacterial eradication [8] but it is not clear whether extended infusion also reduces the emergence of resistance.
Importantly, extended infusion regimens are a cost-effective strategy.
Continuous or extended infusion could maximize the pharmacodynamics of β-lactams [ 14].
CI, continuous infusion; EI, extended infusion; LD, loading dose; MD, maintenance dose; ND, not defined; q × h, every × hours.
Options to maximize the PK-PD of beta-lactams include more frequent dosing, continuous infusions, and extended infusion.
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Alternatively, prolonging the infusion time via extended-infusion (EI), also has been suggested to maximize the f T>MIC for this antibiotic class without some of the CI-associated drawbacks outlined in Table 1 [48] 48].
This study was conducted to identify optimal dosage regimens and estimate pharmacokinetic/pharmacodynamic (PK/PD) characteristics of short-infusion (SI) versus extended-infusion (EI) biapenem against Pseudomonas aeruginosa infections in Chinese intensive care unit (ICU) patients.
Extended-infusion regimens maintained the piperacillin concentration above the MIC for a greater proportion of the dosing interval.
This corresponds to plasma Cmin/MIC ratios of 3.4 and 10.4 for the bolus and extended-infusion regimens, respectively, assuming that piperacillin protein binding is 30%.
It would also eliminate statistically significant mortality improvements in the subgroup of extended-infusion cohort studies, and the subgroup of carbapenem studies.
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