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Continuous vs. intermittent meropenem infusion in critically ill patients with sepsis: a systematic review and

Youquan Wang1, Yanhua Li1, Meng Gao1

  • 1Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China.

Frontiers in Medicine
|June 25, 2025
PubMed
Abstract

Insights

Continuous infusion (CI) of meropenem did not improve mortality in critically ill sepsis patients. However, CI was linked to shorter ICU stays and better cure rates, warranting further investigation.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • A recent large multicenter randomized controlled trial (RCT) indicated continuous infusion (CI) of meropenem did not improve clinical outcomes in critically ill patients.
  • This finding contradicted previous meta-analysis results, creating a need for further clarification.

Purpose of the Study:

  • To evaluate the efficacy of continuous infusion (CI) versus intermittent infusion (II) of meropenem in critically ill patients with sepsis.
  • To analyze the impact of CI meropenem on mortality, clinical cure rates, and duration of therapy.

Main Methods:

  • A systematic review and meta-analysis of five RCTs involving 1,075 critically ill patients with sepsis.
  • Searched PubMed, EMBASE, and Cochrane databases up to March 19, 2024.

Main Results:

  • CI meropenem did not significantly reduce all-cause mortality (RR = 0.89; 95% CI, 0.75-1.04; P = 0.15).
  • Patients receiving CI experienced shorter ICU length of stay (MD = -2.39 days; P < 0.00001) and higher clinical cure rates (RR = 1.88; P = 0.004).
  • CI also led to a shorter duration of meropenem therapy (MD = -0.86 days; P = 0.0008).

Conclusions:

  • Continuous infusion of meropenem in critically ill sepsis patients did not decrease mortality.
  • CI meropenem was associated with improved secondary outcomes, including shorter ICU stays and higher cure rates.
  • Further large-scale RCTs are recommended to confirm these findings.
Keywords:
continuous infusioncritical illnessintermittent infusionmeropenemsepsis

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