Penetration of meropenem into human pancreatic juice

Area of Science:

• Pharmacokinetics
• Surgical Infections
• Antimicrobial Therapy

Background:

• Meropenem is a broad-spectrum carbapenem antibiotic.
• Effective treatment of pancreatic infections requires adequate drug concentrations at the infection site.
• Pancreatic juice penetration of antibiotics is often limited.

Purpose of the Study:

• To evaluate meropenem concentrations in pancreatic juice after administration in patients undergoing hepato-biliary-pancreatic surgery.
• To determine the ratio of meropenem concentration in pancreatic juice to plasma.
• To assess if the standard meropenem regimen achieves therapeutic drug exposure in pancreatic juice.

Main Methods:

• Patients undergoing hepato-biliary-pancreatic surgery received a 500 mg meropenem infusion.
• Plasma and pancreatic juice samples were collected to measure meropenem concentrations.
• Drug concentration-time profiles and ratios were calculated.

Main Results:

• Meropenem plasma concentration peaked at 39.1 μg/ml, while pancreatic juice concentration reached 2.12 μg/ml.
• The pancreatic juice to plasma ratio for maximum concentration and AUC was consistently low (0.06).
• The standard meropenem regimen achieved >40% time above MIC in pancreatic juice for 99.4% and 87.3% of the dosing interval at 0.125 and 0.25 μg/ml, respectively.

Conclusions:

• Meropenem exhibits limited penetration into pancreatic juice.
• The standard meropenem regimen (500 mg TID) is effective in achieving therapeutic drug exposure in pancreatic juice for treating infections.
• This regimen supports the use of meropenem for pancreatic infections despite its low penetrability.