Related Experiment Video
Updated: Aug 2, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Evaluation of the meropenem dosage and administration schedule in patients with bacteremia initial therapy
Tatsuya Tai1, Takaaki Yamamoto1, Kazunori Yamaguchi1
1Department of Pharmacy, Kagawa University Hospital, 1750-1, Ikenobe, Miki, Kagawa, 761-0793, Japan.
Background:
The standard meropenem (MEPM) regimen allowed by insurance in Japan is 0.5 g two or three times a day. Differences in dosages and administration schedules in Japan were evaluated.
Methods:
Patients with bacteremia for whom MEPM was used as the initial treatment at our institution between 2016 and 2021 were included. We retrospectively investigated patients classified into two groups: those treated according to severe infections (high-dose groupand others (low-dose group). After propensity score matching, we compared the probability of achieving free drug blood levels above the minimum inhibitory concentration (MIC) in 24 h (%fT > MIC) and outcomes.
Results:
The probability of 100% fT > MIC was significantly higher in the high-dose group (96.4% vs 74.5%, odds ratio [OR] = 0.3, 95% confidence interval [CI] = 0.2-0.4, P = < 0.001). Regarding outcomes, the 30-day mortality rate was significantly lower in the high-dose group (1.4% vs. 11.4%, OR = 8.0, 95% CI = 1.5-43.7, P = 0.019).
Conclusions:
To improve outcomes in patients with bacteremia treated with MEPM, support for appropriate antimicrobial use is necessary for compliance with the dosage and administration schedule according to severe infections in initial treatment.
Insights
Higher doses of meropenem (MEPM) significantly improved treatment outcomes and reduced mortality in patients with bacteremia. Appropriate dosing is crucial for effective initial treatment of severe infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- The standard meropenem (MEPM) dosage in Japan is often 0.5 g two or three times daily, potentially differing from optimal regimens.
- Variations in MEPM dosing and administration schedules exist within Japan.
Purpose of the Study:
- To evaluate the impact of different meropenem (MEPM) dosages on achieving therapeutic drug levels and patient outcomes in bacteremia.
- To compare high-dose versus low-dose MEPM regimens in patients with bacteremia.
Main Methods:
- Retrospective analysis of patients with bacteremia treated with MEPM between 2016 and 2021.
- Patients were divided into high-dose (severe infections) and low-dose groups.
- Propensity score matching was used to compare %fT > MIC and clinical outcomes.
Main Results:
- The high-dose MEPM group achieved significantly higher probability of 100% fT > MIC (96.4% vs 74.5%).
- The 30-day mortality rate was significantly lower in the high-dose group (1.4% vs. 11.4%).
Conclusions:
- Higher meropenem (MEPM) dosage is associated with improved pharmacokinetic targets and better clinical outcomes in bacteremia.
- Adherence to appropriate dosing and administration schedules for severe infections is essential for initial MEPM treatment to enhance patient outcomes.
More Related Videos
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:17Urinary Tract Infection IV: Nursing Management
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...