Author: Dr Menino Cotta, Postdoctoral Research Fellow, UQ School of Pharmacy and Adjunct Lecturer, Burns Trauma and Critical Care Research Centre, UQ School of Medicine.

A University of Queensland randomised controlled trial is set to determine the optimal way to administer antiobiotics for critically ill patients with severe sepis. 

The Beta-Lactam Infusion Group (BLING) III study will investigate whether continuous 24-hour infusion or intermittent infusion of beta-lactam antibiotics will result in better patient outcomes.

BLING III is a planned international multicentre study involving 7,000 patients across 100 intensive care units which is designed to provide pivotal evidence to answer the fundamental clinical question of optimal beta-lactam antibiotic dosing.

This large-scale study led by UQ investigators including Professor Jeffrey Lipman, Professor Jason Roberts, Dr Joel Dulhunty, Dr Os Cotta, and Professor David Paterson will commence at the beginning of 2017 pending confirmation of National Health and Medical Research Council (NHMRC) funding.

As part of the study, eligible critically ill patients commenced on one of two beta-lactam antibiotics (meropenem or piperacillin-tazobactam) will be randomised to receive the study drug as either a 24-hour continuous infusion or traditional intermittent dosing.

Clinical outcomes for BLING III will be clinical cure, 90-day hospital mortality and acquisition of colonisation with multi-drug resistant organisms. A health economic analysis in a subgroup of study patients will also be undertaken.

The potential significance of this landmark study is that it will provide definitive and globally generisable information on the optimal method of beta-lactam antibiotic dosing, which may lead to a simple and cost-effective intervention to improve survival for critically ill patients with life-threatening infections.