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Meropenem administered as a prolonged infusion to treat serious gram-negative central nervous system infections

Blair Capitano1, David P Nicolau, Brian A Potoski

  • 1Antibiotic Management Program, Department of Pharmacy and Therapeutics, Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Pharmacotherapy
|June 30, 2004
PubMed

Insights

High-dose meropenem infusions successfully treated gram-negative central nervous system (CNS) infections. Achieving target drug concentrations in cerebrospinal fluid (CSF) optimized treatment for these challenging infections.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Pharmacology

Background:

  • Central nervous system (CNS) infections caused by gram-negative bacteria are difficult to treat.
  • Antibiotic resistance and poor penetration into cerebrospinal fluid (CSF) complicate treatment strategies.

Observation:

  • Two patients with gram-negative CNS infections were treated.
  • Treatment involved high-dose, prolonged infusions of meropenem.

Findings:

  • Successful treatment outcomes were achieved in both patients.
  • Meropenem concentrations in CSF consistently exceeded the minimum inhibitory concentration (MIC) of the causative pathogens.
  • Pharmacodynamic targets were maximized, ensuring bactericidal activity throughout the dosing interval.

Implications:

  • This approach demonstrates the practical application of optimizing antibiotic dosing for difficult CNS infections.
  • Maximizing pharmacodynamic targets can improve treatment efficacy for challenging gram-negative CNS infections.
  • Further investigation into high-dose meropenem strategies for CNS infections is warranted.

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