This study is comparing two administration methods for beta-lactam antibiotics: continuous infusion, given continuously over 24 hours, or intermittent infusion, given at regular intervals over 24 hours. The purpose of this study is to determine whether seriously ill adults with severe infection who receive a beta-lactam antibiotic via continuous IV infusion compared with intermittent IV infusion (for 30 minutes every 6 or 8 or 12 hours) will have an improved outcome 90 days later. This study will allow doctors to make informed decisions about the best administration method for beta-lactam antibiotics.
Beta-lactam antibiotics are a group of antibiotics commonly used to treat infection in patients who are seriously ill. Currently, beta-lactam antibiotics are most commonly given to patients as intermittent infusions (given at regular intervals) throughout 24 hours. However, giving the beta-lactam antibiotic as a continuous infusion may mean that antibiotic concentrations in the blood remain more consistent and may be more effective at killing bacteria. Previous studies in humans have not been large enough to show if there is any benefit to the patient by giving beta-lactam antibiotics this way. The purpose of this research is to explore whether beta-lactam antibiotics, commonly used in the treatment of sepsis (a life threatening complication of infection), work better when they are administered by 24 hour continuous infusion as opposed to multiple intermittent infusions each day. This study is part of an international multicentre clinical trial involving 7000 participants to answer this important clinical question. These sort of antibiotics are a vital part of our treatment for people with severe infections so it is important we know how to use them in the most effective way. All of the antibiotics used in this study (i.e. piperacillin-tazobactam and meropenem) are registered drugs currently used in the treatment of sepsis. In this trial we are investigating the delivery method for these drugs.