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Title: Pharmacokinetics of short versus extended infusion meropenem dosing in critically ill patients: a pilot study.
Austin Authors: Langan, Katherine M;Jacob, Jovan;Li, Jian;Nation, Roger L;Bellomo, Rinaldo ;Howden, Benjamin P ;Johnson, Paul D R 
Affiliation: Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Issue Date: 1-Sep-2014
Publication information: Critical Care and Resuscitation; 16(3): 190-6
Abstract: To test whether a prolonged 3-hour infusion of meropenem 500mg achieves an equivalent proportion of time above the minimal inhibitory concentration (MIC) (%TMIC) to that of meropenem 1000mg given over 30 minutes.A randomised crossover study in 10 critically ill patients.We administered meropenem as a 1000mg, 30-minute infusion or as a 500mg, 3-hour infusion. We determined serial plasma concentrations for each dosing episode and performed comparisons of %TMIC at different MICs.The percentage of time that meropenem was above its MIC.For low MICs (≤2 mg/L), both regimens attained a %TMIC >40% in all patients. For an MIC of 4mg/L, this target was attained in all but one patient, but with an MIC of 8mg/L, three patients in each group had a %TMIC <40%. There was no difference in target attainment between the two regimens for MICs up to 8mg/L. There was marked variability in the pharmacokinetic and hence the pharmacokinetic-pharmacodynamic parameters between individuals. Several patients had elevated creatinine clearances and, with both regimens, their target attainment was poor.Meropenem at 1000mg over 30 minutes achieved a similar %TMIC to meropenem at 500mg given over 3 hours. Meropenem pharmacokinetics were highly variable from individual to individual.
Gov't Doc #: 25161021
Type: Journal Article
Subjects: Adult
Anti-Bacterial Agents.administration & dosage.blood.pharmacokinetics
Critical Illness
Cross-Over Studies
Infusions, Intravenous.methods
Microbial Sensitivity Tests
Middle Aged
Pilot Projects
Prospective Studies
Thienamycins.administration & dosage.blood.pharmacokinetics
Appears in Collections:Journal articles

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