Related Experiment Video
Updated: Jun 22, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Usage of Meropenem Continuous Infusion for Treatment of Infectious Complications in Orthopedic Elderly Patients with
Aidos Konkayev1,2, Assiya Kadralinova1,2, Benazir Azimova1,2
1Department of Anesthesiology and Intensive Care, National Scientific Center of Traumatology and Orthopedics Named after Academician N.D. Batpenov, Astana 010000, Kazakhstan.
Abstract:
Background and Objectives: The prolonged infusion of meropenem is recommended by guidelines for the treatment of sepsis. However, studies provide controversial data on the advantages of prolonged infusions over intermittent ones. In our opinion, this can be related to age, which possibly distorts the final data, as older people have age-related characteristics. In our study, we analyzed the ventilatory status, laboratory tests and vital signs of the patient and carried out microbiological cultures. Materials and Methods: This was a prospective single-center case series investigation conducted from June 2022 to June 2023. The objective of this study was to evaluate the effectiveness of continuous infusion in elderly patients with severe infectious complications after orthopedic interventions. The primary endpoints were 28-day survival and the emergence of new multidrug-resistant strains. Secondary endpoints were long-term mortality and length of stay in the ICU. Results: Three patients (median age 65, 100% female) received a continuous infusion of meropenem. Two patients were alive at hospital discharge, and one patient died on the 105th day of hospitalization. Multi-resistant bacteria were observed in one patient. Conclusions: The use of a continuous meropenem infusion in the complex treatment of purulent-septic complications in elderly patients with periprosthetic infection and anemia probably led to clinical improvement in these case reports. However, the emergence of new pan-resistant strains and overall mortality using this infusion technique remains unclear. Further, high-quality RCTs for the elderly are needed.
Insights
Continuous meropenem infusion may aid elderly patients with severe infections post-orthopedic surgery. However, its impact on multidrug-resistant strains and overall mortality requires further investigation in this population.
Area of Science:
- Infectious Diseases
- Geriatric Medicine
- Pharmacology
Background:
- Prolonged meropenem infusion is recommended for sepsis, but evidence comparing it to intermittent infusions is controversial.
- Age-related factors may influence the outcomes of meropenem infusion strategies.
- Severe infectious complications after orthopedic interventions pose significant challenges, particularly in elderly patients.
Purpose of the Study:
- To evaluate the effectiveness of continuous meropenem infusion in elderly patients with severe infectious complications post-orthopedic surgery.
- To assess the impact of continuous meropenem infusion on 28-day survival and the emergence of multidrug-resistant strains.
- To analyze secondary endpoints including long-term mortality and intensive care unit (ICU) length of stay.
Main Methods:
- Prospective, single-center case series conducted from June 2022 to June 2023.
- Inclusion of elderly patients with severe infectious complications after orthopedic interventions.
- Analysis of ventilatory status, laboratory tests, vital signs, and microbiological cultures.
Main Results:
- Three elderly female patients (median age 65) received continuous meropenem infusion.
- Two patients survived until hospital discharge; one patient died on day 105.
- One patient developed multi-resistant bacteria during treatment.
Conclusions:
- Continuous meropenem infusion may contribute to clinical improvement in elderly patients with periprosthetic infections and anemia.
- The effect of this infusion method on the emergence of pan-resistant strains and overall mortality in the elderly remains uncertain.
- Further high-quality randomized controlled trials (RCTs) specifically for the elderly population are necessary to clarify these findings.
Related Concept Videos
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:
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...