Intermittent and continuous ceftazidime infusion for critically ill traumapatients

BACKGROUND: The adequacy of intermittent and continuous infusion ceftazidim e for the treatment of nosocomial pneumonia in critically ill trauma patien ts was assessed by analyzing ceftazidime pharmacokinetics in relation to th e minimum inhibitory concentration (MIC) and treatment outcome. METHODS: Serial blood samples were obtained during ceftazidime therapy in 3 1 trauma patients. Ceftaridime pharmacokinetics were compared with that of previously studied healthy volunteers. Ceftazidime pharmacokinetics were an alyzed according to the time above the MIC and treatment outcome. RESULTS: Critically ill trauma patients had a significantly increased volum e of distribution and clearance (0.32 +/- 0.14 L/kg and 2.35 a 0.89 mL . mi n(-1) . kg(-1), respectively) compared with healthy volunteers (0.21 +/- 0. 03 and 1.58 +/- 0.23 mL . min(-1) . kg(-1)). The time above the MIC was gre ater than or equal to 92% of the dosing interval for all patients and treat ment outcomes were similar between the two treatment groups. CONCLUSIONS: Ceftazidime pharmacokinetics are significantly altered in crit ically ill trauma patients. Both intermittent and continuous ceftazidime re gimens were equally effective for the treatment of nosocomial pneumonia cau sed by less virulent bacteria. (C) 2000 by Excerpta Medica, Inc.