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 Cl 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 mu g/mL; half-life, 1.9 +/- 0.6 hours; and total body clearance (Cl-T), 162.8 +/- 42.7 mL/min. The mean steady concentration achieved with the 3-g Cl dose was 15.3 +/- 4.2 mu g/mL, whereas the Cl, 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, Cl therapy seems to optimize the pharmacodynamic and pharmacoeconomic profile of ceftazidime by providing adequate concentrations over the 24-hour dosing period with a reduction in the total daily dose.