Meropenem: continuous or extended infusion?

• Published in: Critical care (London, England) England), 2020-05, Vol.24 (1), p.192-192, Article 192
• Main Authors: Frippiat, Frédéric, Vercheval, Christelle, Layios, Nathalie
• Format: Article
• Language: English
• Subjects: Anesthesia & intensive care; Anesthésie & soins intensifs; Anti-Bacterial Agents; Critical care; Critical Illness; Cross Infection; Human health sciences; Humans; Immunologie & maladie infectieuse; Immunology & infectious disease; Letter; Meropenem; Pneumonia; Sciences de la santé humaine; Thienamycins
• ISSN: 1364-8535; 1466-609X; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-020-02883-w

[...]the pharmacokinetic/pharmacodynamic (PK/PD) target was a free epithelial lining fluid (ELF) concentration of 50% of time above MIC (50% fT > MIC). [...]considering a target of 50% fT > MIC, similar results were obtained with both extended infusion (EI) over 4 h and CI (i.e., MIC up to 1 and up to 2 mg/L for both modes of infusion with 1 g/8 h and 2 g/8 h, respectively), which are close to our results with EI over 3 h (i.e., MICS up to 0.5 and up to 1 mg/L with 1 g/8 h and 2 g/8 h, respectively) [4]. [...]CI does not offer significant PK/PD advantages over EI for meropenem. [...]when meropenem is considered as the initial empiric antibiotic therapy for nosocomial pneumonia in critically ill patients, we strongly recommend the dosage of 2 g/8 h by EI over 3 h (or by CI if the cartridge is changed every 5–8 h and the temperature remains below 25 °C) to optimize chances for therapeutic concentrations in ELF.