Meropenem serum concentrations in intensive care patients: a retrospective analysis.

To determine whether currently used meropenem dosages in our hospital provide adequate serum concentrations. Trough blood samples taken during the first meropenem concentration monitoring were included. For the evaluation of achievement of the pharmacokinetic/pharmacodynamic (PK/PD) target, MIC of the pathogens defined by the European Committee on Antimicrobial Susceptibility testing was selected. Eighty three patients were enrolled. A large variability in meropenem trough serum concentrations was observed (median 34.3 mg/L, range < 1.0-146.1 mg/L). The lowest PK/PD target for susceptible pathogens (100% T > MIC) was achieved in 100% of patients on dialysis and continuous renal replacement therapy (CRRT) and in 91% non-RRT patients. For pathogens with intermediate susceptibility, 100% T > MIC was attained in all patients on CRRT and 96% on dialysis, only 74% non-RRT patients achieved this PK/PD target. Patients on RRT were more likely to achieve the highest PK/PD target 100% T > 5 × MIC, P < 0.05. Higher proportion of patients on RRT would also require meropenem dose reduction if upper limit 100% T > 10 × MIC was chosen, P < 0.05. Administration of a standard meropenem dose to critically ill patients leads to a large concentration variability. Thus, a personalised dosing regimen is crucial for the achievement of adequate meropenem exposure.

Citation

Jana Uricová, Ivana Kacířová, Hana Brozmanová. Meropenem serum concentrations in intensive care patients: a retrospective analysis. Ceska a Slovenska farmacie : casopis Ceske farmaceuticke spolecnosti a Slovenske farmaceuticke spolecnosti. 2020;69(5-6):230-236

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PMID: 33736449

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