Continuous versus intermittent administration of ceftazidime in intensive care unit patients with nosocomial pneumonia

A prospective, randomized pilot study was undertaken to compare the efficac y of continuous versus intermittent ceftazidime in ICU patients with nosoco mial pneumonia. Ceftazidime was administered either as a 3 g/day continuous infusion (CI) or an intermittent infusion (II) of 2 g every 8 h. In additi on, all patients received concomitant once-daily tobramycin. The demographi cs of the evaluable patients (n = 35) were similar between the groups: age (years), CI 46 +/- 16, II 56 +/- 20; Apache score, CI 14 +/- 4, II 16 +/- 6 : time (days) from admission to diagnosis, CI 9 +/- 6, II 9 +/- 6. Clinical efficacy, defined as cure/improvement was similar between groups [n (%), C l 16/17 (94), II 15/18 (83)], while microbiological response was also compa rable [n (%), CI 10/13 (76). II 12/15 (80)]. Minimal inhibitory concentrati ons (MICs) for all isolates were measured throughout the treatment course; there was no development of resistance during therapy for either regimen. W hile limited clinical data exist, our results suggest that the use of cefta zidime by CI administration maintains clinical efficacy, optimizes the phar macodynamic profile and uses less antibiotic compared with the standard 2 g every 8 h intermittent dosing regimen. (C) 2001 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.