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Published on: August 12, 2020
Carbapenem-Resistant Enterobacteriaceae Bloodstream Infection Treated Successfully With High-Dose Meropenem in a
Yue-E Wu1, Hai-Yan Xu2, Hai-Yan Shi3
1Department of Clinical Pharmacy, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China.
Insights
High-dose meropenem with therapeutic drug monitoring successfully treated a premature infant with carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection. This approach enhances antimicrobial efficacy and safety in neonates facing critical infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant global health threat, characterized by high mortality rates.
- Treating CRE infections in premature neonates is challenging due to the risk of inadequate antimicrobial therapy and associated mortality.
- Meropenem is a critical antibiotic, but achieving therapeutic targets in neonates requires careful dosing strategies.
Abstract:
Carbapenem-resistant enterobacteriaceae (CRE) bloodstream infections have been rapidly spreading worldwide with a high mortality and pose a challenge to therapeutic decision-making, especially in premature neonates because insufficient empirical antimicrobial therapy is independently associated with high mortality. This case reported that a premature infant with CRE bloodstream infection was treated successfully with high-dose meropenem treatment with model-based therapeutic drug monitoring (TDM). In clinical settings, treatment target attainment of meropenem can be improved by increasing the frequency of administration, prolonging the infusion time, and using a high dose. This case report shows a successful regimen for CRE infection in a premature neonate and emphasizes the utility of model-based TDM of high-dose meropenem treatment. The adequate antimicrobial benefit provided by innovative techniques could ensure the efficacy and safety of high-dose meropenem therapy for CRE infection.
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