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Optimizing antimicrobial pharmacodynamics: dosage strategies for meropenem
Holly M Mattoes1, Joseph L Kuti, George L Drusano
1Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut 06102, USA.
Clinical Therapeutics
|October 13, 2004
Summary
Optimizing meropenem dosing using pharmacodynamics can improve treatment outcomes for nosocomial infections. Adjusting dosage regimens maximizes antibacterial effectiveness and minimizes resistance development in critical care settings.
Area of Science:
- Pharmacology
- Infectious Diseases
- Critical Care Medicine
Background:
- Carbapenems are crucial last-resort antibiotics for treating nosocomial infections.
- Pharmacodynamic principles are essential for optimizing carbapenem dosage regimens.
- Effective dosing can enhance antibacterial activity and prevent pathogen resistance.
Purpose of the Study:
- To review the application of pharmacodynamics to carbapenem antibiotics, focusing on meropenem.
- To evaluate the clinical utility of pharmacodynamically guided meropenem dosage regimens.
Main Methods:
- Literature search of MEDLINE (1980-present) and conference abstracts (2001-2003).
- Keywords included carbapenem, pharmacodynamics, meropenem, and related terms.
- Included studies demonstrating carbapenem pharmacodynamics with dosage strategy modifications.
Main Results:
- Only meropenem data were identified in the literature search.
- Meropenem dosage can be adjusted to maximize time above minimum inhibitory concentration (MIC).
- Higher doses, increased frequency, or prolonged infusions of meropenem improved pharmacodynamics in simulations and human studies.
Conclusions:
- Applying pharmacodynamic principles to meropenem dosing optimizes clinical and microbiological outcomes.
- Strategic meropenem dosage regimens enhance treatment efficacy against resistant pathogens.