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 < or = 0.001) 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.