Authors: F M Buyle J Decruyenaere J De Waele P M Tulkens T Van Audenrode P Depuydt G Claeys H Robays D Vogelaers
Publish Date: 2012/12/28
Volume: 32, Issue: 6, Pages: 763-768
Abstract
Extended and continuous infusions with betalactam antibiotics have been suggested as a means of pharmacokinetic and pharmacodynamic optimisation of antimicrobial therapy Vancomycin is also frequently administered in continuous infusion although more for practical reasons A survey was undertaken to investigate the recommendations by the local antibiotic management teams AMTs in Belgian acute hospitals concerning the administration intermittent extended or continuous infusion and therapeutic drug monitoring of four betalactam antibiotics ceftazidime cefepime piperacillin–tazobactam meropenem and vancomycin for adult patients with a normal kidney function A structured questionnaire survey comprising three domains was developed and approved by the members of the Belgian Antibiotic Policy Coordination Committee BAPCOC The questionnaire was sent by email to the official AMT correspondents of 105 Belgian hospitals followed by two reminders The response rate was 32 with 94 59 100 100 and 100 of the participating Belgian hospitals using ceftazidime cefepime piperacillin–tazobactam meropenem and vancomycin respectively Comparing intensive care unit ICU with nonICU wards showed a higher implementation of extended or continuous infusions for ceftazidime 81 vs 41 cefepime 35 vs 10 piperacillin–tazobactam 38 vs 12 meropenem 68 vs 35 and vancomycin 79 vs 44 on the ICU wards A majority of the hospitals recommended a loading dose prior to the first dose For vancomycin the loading dose and the trough target concentration were too low based on the current literature This survey shows that extended and continuous infusions with betalactams and vancomycin are widely implemented in Belgian hospitalsWe thank the members of the Hospital Medicine Working Group of the Belgian Antibiotic Policy Coordination Committee BAPCOC for revising the content of the questionnaire and for providing the email addresses of the official contact persons of the antibiotic management teams AMTs in Belgian hospitals
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