Five-year View
The findings of this meta-analysis do not corroborate a comparative clinical advantage of the extended or continuous iv. infusion of third- and fourth-generation cephalosporins over the traditional short-term infusion, albeit this is strongly suggested by the relevant PK/PD considerations. In the majority of the included studies, patients had low APACHE II scores and the responsible pathogens were highly susceptible to the antibiotics administered, while a lower total dosage of antibiotic was administered to patients who received extended or continuous infusion of cephalosporins compared with those who received short-term infusion. Accordingly, future trials are warranted to evaluate whether the administration of cephalosporins in an extended or continuous infusion benefits severely ill patients, assuming that an adequate total daily dosage is given. The proper use of cephalosporins gains further importance given the advent of fifth-generation agents, such as ceftaroline.