Peritoneal pharmacokinetics and pharmacodynamic target attainment of meropenem in patients undergoing abdominal...

Area of Science:

• Pharmacology
• Infectious Diseases
• Surgical Infections

Background:

• Meropenem is a critical antibiotic for intra-abdominal infections.
• Understanding meropenem's peritoneal fluid penetration is essential for optimizing therapy.
• Limited data exists on meropenem concentrations within the abdominal cavity.

Purpose of the Study:

• To evaluate meropenem penetration into peritoneal fluid.
• To determine the probability of target attainment for common intra-abdominal infection pathogens.
• To assess the suitability of standard and high-dose meropenem regimens.

Main Methods:

• Intravenous meropenem (500 mg) administered to 8 patients with inflammatory bowel disease undergoing laparotomy.
• Peritoneal fluid and plasma drug concentrations were measured.
• Monte Carlo simulation used with MIC data to predict target attainment probabilities.

Main Results:

• Meropenem concentrations in peritoneal fluid and plasma were comparable at 1 hour post-infusion.
• High probabilities of target attainment were observed for Bacteroides spp., Escherichia coli, and Pseudomonas aeruginosa with both 500 mg and 1000 mg every 8 hours.
• Probabilities ranged from 76% to 99% depending on the pathogen and dosage.

Conclusions:

• Meropenem demonstrates excellent penetration into peritoneal fluid.
• Both 500 mg every 8 hours and 1000 mg every 8 hours are suitable dosing regimens for intra-abdominal infections.
• These findings support the use of meropenem in treating serious abdominal infections.