Dados do Trabalho

Título

Continuous versus intermittent beta-lactam infusion in patients with sepsis: a systematic review and updated meta-analysis

Objetivo

We sought to compare continuous infusion with intermittent infusion of beta-lactams in patients with sepsis, which remains one of the main questions involving the optimal administration strategy in this healthcare-challenging condition.

Métodos

MEDLINE, Cochrane and Embase databases were systematically searched until June 18, 2023. The data was examined using Mantel-Haenszel method and 95% confidence intervals (CIs). Covariate influence of Sequential Organ Failure Assessment (SOFA) and Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) scores in short-term mortality and ICU mortality were investigated with meta-regression.

Resultados

3 randomized controlled trials and 4 retrospective cohort studies involving 1,968 patients were enrolled. The three main infection sites of sepsis were respiratory, intra-abdominal, and unknown. In comparison to intermittent infusion, the continuous method had a minimized short-term mortality (OR 0.66; 95% CI 0.47–0.92; p=0.01; I²=32%), ICU mortality (OR 0.70; 95% CI 0.50–0.97; p=0.03; I²=45%), and a lower hospital mortality (OR 0.62; 95% CI 0.42–0.90; p=0.01; I²=0%). Long-term mortality and ICU length of stay did not reach a statistically significant difference between groups.

Conclusão

In this meta-analysis, continuous infusion of beta-lactams was associated with reduced short-term mortality, ICU mortality, and hospital mortality.