Related Experiment Videos
Imipenem levels are not predictable in the critically ill patient
Howard Belzberg1, Jay Zhu, Edward E Cornwell
1Department of Surgery, Los Angeles County and University of Southern California Medical Center, 90033, USA. belzberg@usc.edu
The Journal of Trauma
|January 30, 2004
Summary
Critically ill patients exhibit unique imipenem pharmacokinetics, with highly variable drug levels and prolonged half-lives. Dosage adjustments may be needed due to unpredictable drug activity in this population.
Area of Science:
- Pharmacology
- Critical Care Medicine
- Infectious Diseases
Background:
- Critically ill patients often display altered drug pharmacokinetics, including unusual volumes of distribution (Vd) and half-lives (t1/2).
- Imipenem is a frequently prescribed antibiotic for severe infections in intensive care settings.
Purpose of the Study:
- To investigate the pharmacokinetic profile of imipenem in critically ill patients.
- To assess the relationship between imipenem dosage and serum concentrations in this patient group.
Main Methods:
- High-performance liquid chromatography (HPLC) was used to analyze imipenem concentrations.
- Samples were collected from 50 critically ill patients receiving either 500 mg or 1,000 mg of imipenem.
Main Results:
- Imipenem peak serum levels ranged widely (1.56–58.8 µg/mL), and trough levels varied significantly (0.0–15.62 µg/mL).
- Only 54% of patients achieved a trough level above 4 µg/mL, a common therapeutic target.
- The volume of distribution (Vd) and half-life (t1/2) of imipenem were substantially larger than typically observed.
Conclusions:
- Imipenem exhibits distinct pharmacokinetic behavior in critically ill patients compared to other populations.
- A weak correlation exists between imipenem dosage and achieved serum concentrations.
- Unpredictable pharmacodynamics, specifically Vd and t1/2, may contribute to therapeutic failures in critically ill surgical patients.