Therapeutic Target Attainment of 3-Hour Extended Infusion of Meropenem in Patients With Septic Burns

Clin Ther. 2022 Apr;44(4):624-629. doi: 10.1016/j.clinthera.2022.02.007. Epub 2022 Mar 6.

Abstract

Purpose: The aim of this prospective cohort study was to evaluate the therapeutic target attainment of 3-hour extended infusion of meropenem in patients with septic burns in the early and late periods of septic shock.

Methods: Meropenem serum levels were determined by liquid chromatography from blood samples collected within 48 hours (early period) of therapy and 10 to 14 days afterward (late period). Pharmacokinetic properties were investigated by noncompartmental analysis, and the therapeutic target was defined as 100% of the time above the MIC (100%fT> MIC).

Findings: Fifteen patients with 90 measured meropenem concentrations were included. Throughout the entire course of antimicrobial therapy, the therapeutic target was attained against gram-negative pathogens with an MIC ≤ 2 mg/L. Pathogens with intermediate susceptibility to meropenem were only covered in the early phase of therapy.

Implications: Higher-dose regimens or continuous infusions may be necessary to guarantee antimicrobial coverage of meropenem against less sensitive pathogens in patients with septic burns.

Keywords: burns; meropenem; pharmacodynamics; pharmacokinetics; sepsis.

MeSH terms

  • Anti-Bacterial Agents
  • Burns* / drug therapy
  • Critical Illness
  • Humans
  • Infusions, Intravenous
  • Meropenem / pharmacokinetics
  • Microbial Sensitivity Tests
  • Prospective Studies
  • Shock, Septic* / drug therapy
  • Thienamycins / pharmacokinetics

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Meropenem