ICU SAQs · Infection / pharmacology
Beta-lactam choice in the severe sepsis and the beta-lactam allergy
A CICM SAQ on the beta-lactams — the time-dependent dosing, the choice for the Gram-negative cover (the piperacillin-tazobactam, the meropenem, the cefepime), and the penicillin-allergy handling (the aztreonam, the low cross-reactivity).
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Prompt
A septic patient with the penicillin allergy and the suspected Gram-negative pneumonia needs the antibiotics. Discuss the beta-lactam options and the principles.
Question
A septic patient with the penicillin allergy and the suspected Gram-negative pneumonia needs the antibiotics. Discuss the beta-lactam options and the principles.[1]
References3ShowHide
- [1]Dulhunty JM, Brett SJ, De Waele JJ, et al. Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial JAMA, 2024.PMID 38864155
- [2]Abdul-Aziz MH, Hammond NE, Brett SJ, et al. Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock: A Systematic Review and Meta-analysis JAMA, 2024.PMID 38864162
- [3]Luther MK, Timbrook TT, Caffrey AR, et al. Vancomycin Plus Piperacillin-Tazobactam and Acute Kidney Injury in Adults: A Systematic Review and Meta-analysis Crit Care Med, 2018.PMID 29088001