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Meropenem pharmacokinetics in a patient with multiorgan failure from Meningococcemia undergoing continuous venovenous

M M Meyer1, M Y Munar, S J Kohlhepp

  • 1Department of Medicine, Oregon Health Sciences University, Portland, OR, USA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|April 9, 1999
PubMed

Insights

Determining the correct meropenem dosage for patients on continuous venovenous hemodiafiltration (CVVHDF) is crucial. A 1g dose every 12 hours is recommended for effective treatment of severe infections like meningococcemia.

Area of Science:

  • Pharmacology
  • Nephrology

Background:

  • Meropenem, a broad-spectrum carbapenem antibiotic, is primarily renally eliminated.
  • Dosing adjustments are necessary in renal impairment, but optimal doses for continuous venovenous hemodiafiltration (CVVHDF) remain undefined.

Observation:

  • This study evaluated meropenem pharmacokinetics in a patient with fulminant meningococcemia undergoing CVVHDF.
  • Serial drug concentrations were measured using high-performance liquid chromatography (HPLC).

Findings:

  • Meropenem clearance was determined to be 129.36 mL/min and 141.29 mL/min for 8- and 12-hour dosing intervals, respectively.
  • Achieved trough levels exceeded the MIC90 for Neisseria meningitidis and key anaerobic pathogens.

Implications:

  • A meropenem dose of 1g intravenously every 12 hours is proposed as an initial regimen for patients on CVVHDF.
  • Understanding meropenem clearance during CVVHDF aids in optimizing antibiotic therapy for critically ill patients with renal failure.

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