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Differential analysis of clinical efficacy on patients with serious infection in ICU by different meropenem regimens
Wei-Min Wang1, Xu-Sheng An2, Xiang-Cheng Zhang3
1Huai'an Traditional Chinese Medicine Hospital, China.
Abstract:
To investigate the difference in clinical efficacy and safety of different meropenem regimens on patients with serious infection in ICU. Then, 228 patients with serious infection in ICU were divided by random into control group (intermittent administration in 1000mg/30min single dose) and research group (continuous administration in 200mg/10min +800mg/180min), respectively. The blood concentration of meropenem were recorded in two groups at different time points, and difference in treatment effectiveness, iconographic effectiveness, bacterial eradication rate, 28-day survival rate and many other clinical scoring indices (SOFA, APACHEII, CPIS, and SIRS) were compared between two groups. There were 212 patients completing the whole research, including 104 patients in research group and 108 patients in control group. The difference in treatment effectiveness (77.8% vs 53.7%), iconographic effectiveness (51.0% vs 18.5%), and 28-day survival rate (86.5% vs 64.8%) between two groups performed statistical significance (P<0.05). However, the difference in bacterial eradication rate (48.0% vs 46.3%) performed no statistical significance. Eight hours later, the difference in average blood concentration between two groups (9.61±3.63μg/ml vs 1.5±0.51μg/ml) showed statistical significance. Moreover, the difference in clinical scoring indices except APACHE II score between two groups performed statistical significance. It was helpful to maintain the blood concentration of meropenem by extending the transfusion time. Therefore, it could increase the clinical cure rate and 28-day survival of patients with serious infection in ICU, improve clinical indices, and reduce the usage amount of antibiotics.
Insights
Continuous meropenem infusion significantly improves clinical outcomes and survival rates in intensive care unit (ICU) patients with serious infections compared to intermittent dosing. This method enhances meropenem blood concentration, increasing cure rates and reducing antibiotic use.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pharmacology
Background:
- Serious infections in the intensive care unit (ICU) require effective antibiotic regimens.
- Meropenem is a broad-spectrum antibiotic used for severe bacterial infections.
- Optimizing meropenem administration may improve patient outcomes.
Purpose of the Study:
- To compare the clinical efficacy and safety of continuous versus intermittent meropenem administration in ICU patients.
- To evaluate the impact of different meropenem regimens on blood concentration, treatment effectiveness, and survival rates.
Main Methods:
- A randomized controlled trial involving 228 ICU patients with serious infections.
- Patients were assigned to either continuous meropenem infusion (200mg/10min + 800mg/180min) or intermittent administration (1000mg/30min).
- Clinical efficacy, safety, blood concentrations, bacterial eradication, and survival rates were assessed.
Main Results:
- Continuous infusion showed significantly higher treatment effectiveness (77.8% vs 53.7%) and 28-day survival rates (86.5% vs 64.8%) (P<0.05).
- Higher average meropenem blood concentrations were observed with continuous infusion at 8 hours (9.61±3.63μg/ml vs 1.5±0.51μg/ml).
- Continuous infusion improved clinical scoring indices (SOFA, CPIS, SIRS) and iconographic effectiveness, but bacterial eradication rates were similar.
Conclusions:
- Continuous meropenem infusion is more effective than intermittent dosing for treating serious ICU infections.
- Extended transfusion time helps maintain optimal meropenem blood levels, leading to improved clinical cure rates and survival.
- Continuous infusion may allow for reduced antibiotic usage while enhancing therapeutic benefits.