Čes. slov. farm. 2020, 69(5):230-236 | DOI: 10.36290/csf.2020.032

Meropenem serum concentrations in intensive care patients: a retrospective analysis

Jana Ďuricová^1,2,*, Ivana Kacířová^1,2, Hana Brozmanová^1,2

¹ Department of Clinical Pharmacology, Department of Laboratory Diagnostics, University Hospital Ostrava, Czech Republic

² Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Czech Republic

Objectives: To determine whether currently used meropenem dosages in our hospital provide adequate serum concentrations.

Methods: Trough blood samples taken during the first meropenem concentration monitoring were included. For the evaluation of achievement of the pharmacokinetic/pharmacodynamic (PK/PD) target, MIC of the pathogens defined by the European Committee on Antimicrobial Susceptibility testing was selected.

Results: Eighty three patients were enrolled. A large variability in meropenem trough serum concentrations was observed (median 34.3 mg/L, range < 1.0-146.1 mg/L). The lowest PK/PD target for susceptible pathogens (100% T > MIC) was achieved in 100% of patients on dialysis and continuous renal replacement therapy (CRRT) and in 91% non-RRT patients. For pathogens with intermediate susceptibility, 100% T > MIC was attained in all patients on CRRT and 96% on dialysis, only 74% non-RRT patients achieved this PK/PD target. Patients on RRT were more likely to achieve the highest PK/PD target 100% T > 5 × MIC, P < 0.05. Higher proportion of patients on RRT would also require meropenem dose reduction if upper limit 100% T > 10 × MIC was chosen, P < 0.05.

Conclusions: Administration of a standard meropenem dose to critically ill patients leads to a large concentration variability. Thus, a personalised dosing regimen is crucial for the achievement of adequate meropenem exposure.

Keywords: meropenem; trough concentrations; MIC; pharmacokinetic, pharmacodynamic target

Received: November 6, 2020; Accepted: December 2, 2020; Published: May 1, 2020  Show citation