Comparison of the pharmacodynamics of meropenem in patients with ventilator-associated pneumonia following administration by 3-hour infusion or bolus injection

S Jaruratanasirikul, S Sriwiriyajan… - Antimicrobial agents and …, 2005 - Am Soc Microbiol
S Jaruratanasirikul, S Sriwiriyajan, J Punyo
Antimicrobial agents and chemotherapy, 2005Am Soc Microbiol
The time that concentrations in serum are above the MIC (T> MIC) is the pharmacokinetic/
pharmacodynamic parameter correlating with the therapeutic efficacy of β-lactam antibiotics.
The aim of this study was to demonstrate the T> MIC of meropenem when administered by a
3-h infusion compared with that when administered by bolus injection. The study was
conducted with nine patients with ventilator-associated pneumonia. Each subject received
meropenem in three regimens consecutively:(i) bolus injection of 1 g every 8 h for 24 h;(ii) 3 …
Abstract
The time that concentrations in serum are above the MIC (T>MIC) is the pharmacokinetic/pharmacodynamic parameter correlating with the therapeutic efficacy of β-lactam antibiotics. The aim of this study was to demonstrate the T>MIC of meropenem when administered by a 3-h infusion compared with that when administered by bolus injection. The study was conducted with nine patients with ventilator-associated pneumonia. Each subject received meropenem in three regimens consecutively: (i) bolus injection of 1 g every 8 h for 24 h; (ii) 3-h infusion of 1 g every 8 h for 24 h; and (iii) 3-h infusion of 2 g every 8 h for 24 h. Following bolus injection, the percentages of the T>MICs of 16, 8, 4, and 1 μg/ml were 28.33% ± 11.67%, 45.89% ± 22.90%, 57.00% ± 24.82%, and 74.67% ± 17.94% of an 8-h interval, respectively. For the 3-h infusion of 1 g of meropenem, the percentages of the T>MICs of 16, 8, 4, and 1 μg/ml were 37.78% ± 20.57%, 58.11% ± 24.38%, 72.67% ± 21.97%, and 93.56% ± 6.84% of an 8-h interval, respectively. For the 3-h infusion of 2 g of meropenem, the percentages of the T>MICs of 16, 8, 4, and 1 μg/ml were 57.89% ± 24.26%, 72.89% ± 22.40%, 85.56% ± 16.42%, and 98.56% ± 3.28% of an 8-h interval, respectively. In conclusion, a 3-h infusion resulted in greater T>MICs than those after a bolus injection. For the treatment of infections caused by pathogens with intermediate resistance, a 3-h infusion of 2 g of meropenem every 8 h can provide concentrations in serum above the MIC of 16 μg/ml for almost 60% of an 8-h interval.
American Society for Microbiology
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