PHARMACOKINETICS OF CONTINUOUS AND INTERMITTENT CEFTAZIDIME IN INTENSIVE CARE UNIT PATIENTS WITH NOSOCOMIAL PNEUMONIA

Intensive care unit patients with nosocomial pneumonia participating in a prospective, randomized trial comparing the efficacy of intermittent infusion (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 CI over 24 hours were compared. Patients (II, n = 13; CI, n = 11) were well matched for demographic variables. The mean pharmacokinetic parameters (mean ± SD) for patients receiving the q8h II dose were as follows: maximum concentration in serum, 105.3 ± 28.0 μg/mL; half-life, 1.9 ± 0.6 hours; and total body clearance (CIT), 162.8 ± 42.7 mL/min. The mean steady concentration achieved with the 3-g CI dose was 15.3 ± 4.2 μg/mL, whereas the CIT was similar at 143.6 ± 30.1 mL/min. Although clinical trial data are required to fully evaluate the efficacy of different antimicrobial administration techniques, CI therapy seems to optimize the pharmacodynamic and phar-macoeconomic profile of ceftazidime by providing adequate concentrations over the 24-hour dosing period with a reduction in the total daily dose.