Tractable targets for meropenem-sparing antimicrobial stewardship interventions.

Area of Science:

• Infectious Diseases
• Clinical Pharmacy
• Antimicrobial Stewardship

Background:

• Meropenem is a restricted antimicrobial agent.
• Real-world usage data is crucial for broader antimicrobial stewardship (AMS) insights.

Purpose of the Study:

• To retrospectively evaluate meropenem usage in UK tertiary care hospitals.
• Identify key areas for targeted AMS interventions to optimize meropenem prescribing.

Main Methods:

• Retrospective review of 107 adult inpatients receiving meropenem.
• Analysis of clinical records and microbiology results.
• Evaluation of meropenem indication, duration, and rationalization.

Main Results:

• Meropenem was used as first-line therapy in 47% and escalation in 53% of cases.
• Source control was needed in 28% of escalated cases.
• Rationalization occurred in 24% of cases, facilitated by positive microbiology and specialist input.

Conclusions:

• Microbiological sampling, source control, and infection specialist input are key targets for AMS.
• Supporting rationalization to carbapenem-sparing agents and restricting first-line meropenem are recommended.
• Selective reporting of meropenem susceptibility may enhance stewardship efforts.