Cost-effectiveness of ceftazidime by continuous infusion versus intermittent infusion for nosocomial pneumonia

Study Objective. To determine if continuous-infusion ceftazidime is more cost-effective and efficacious than intermittent infusion in patients with nosocomial pneumonia. Design. Prospective, open-label, randomized trial. Setting. Large, community teaching hospital. Patients. Intensive care unit (ICU) patients with nosocomial pneumonia. Interventions. Ceftazidime 3 g/day was administered as a continuous infusion or as 2 g 3 times/day by intermittent infusion to treat nosocomial pneumonia in the ICU. Patients also received tobramycin 7 mg/kg once/day. Measurements and Main Results. Thirty-five patients were evaluable; 17 received continuous infusion and 18 intermittent infusion. Clinical efficacy (94% and 83% successful outcomes with continuous and intermittent infusion, respectively), adverse events, and length of stay did not vary significantly between groups. Costs associated with continuous infusion, $627 +/- 388, were significantly lower (p less than or equal to0.001) than with intermittent infusion, $1007 +/- 430. Conclusions. Continuous infusion of ceftazidime is a cost-effective alternative to intermittent infusion for nosocomial pneumonia in the ICU.