Pharmacokinetics of continuous and intermittent ceftazidime in intensive care unit patients with nosocomial pneumonia

Intensive care unit patients with nosocomial pneumonia participating in a p rospective, randomized trial comparing the efficacy of intermittent infusio n (II) or continuous infusion (CI) ceftazidime plus an aminoglycoside were studied. The pharmacokinetic profile of ceftazidime administered as either 2 g q8h IV or 3 g Cl over 24 hours were compared. Patients (II, n = 13; CI, n = 11)were well matched for demographic variables. The mean pharmacokinet ic parameters (mean +/- SD) for patients receiving the q8h ii dose were as follows: maximum concentration in serum, 105.3 +/- 28.0 mu g/mL; half-life, 1.9 +/- 0.6 hours; and total body clearance (Cl-T), 162.8 +/- 42.7 mL/min. The mean steady concentration achieved with the 3-g Cl dose was 15.3 +/- 4 .2 mu g/mL, whereas the Cl, was similar at 143.6 +/- 30.1 mL/min. Although clinical trial data are required to fully evaluate the efficacy of differen t antimicrobial administration techniques, Cl therapy seems to optimize the pharmacodynamic and pharmacoeconomic profile of ceftazidime by providing a dequate concentrations over the 24-hour dosing period with a reduction in t he total daily dose.