Optimizing β-lactam antibiotics with the highest concentration-for continuous infusion reduce carbon footprint in intensive care.

BACKGROUND

β-lactam antibiotics are the most commonly used antibiotics to treat infection in critically-ill patients. The modalities of antibiotics reconstitution/preparation for continuous infusion are elaborated according to drug stability. In between 2 periods, a sustainable protocol for 4 common β-lactam antibiotics administration was implemented, consisting of preparing the highest stable concentration for continuous administration through a 50 mL syringe.

RESULTS

Overall, 418 patients were treated (202 in 2024 and 216 in 2025), age, and SAPSII did not differed between both periods. A sustainable protocol implementation reduced the greenhouse gas emission (GHG) by 52% from 2760 [1380-4968]g to 1380 [552-2208]g/treatment, p < 0.0001. The global reduction of plastic consumed (syringes, tubing, solution bags, blister packs) was - 48% (-61 kg), and treatment cost was also reduced by 48% (-1324 €). The total nursing time for preparation was 145 h shorter during the second 6 months period.

DISCUSSION: These results showed that implementation of a sustainable protocol for continuous β-lactam antibiotics can significantly reduce the environmental impact of antibiotic administration.

CONCLUSION

A careful prescription of drug dilution, if continuous infusion of β-lactam antibiotics is used, can be efficient in reducing GHG emissions, consumables, waste, and costs.