Meropenem population pharmacokinetics and model-based dosing optimisation in patients with serious bacterial infection
© European Association of Hospital Pharmacists 2024. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: The objective of this study was to develop a population pharmacokinetic model of meropenem in a heterogeneous population of patients with a serious bacterial infection in order to propose dosing optimisation leading to improved achievement of the pharmacokinetic/pharmacodynamic (PK/PD) target.
METHODS: A total of 174 meropenem serum levels obtained from 144 patients during therapeutic drug monitoring were analysed using a non-linear mixed-effects modelling approach and Monte Carlo simulation was then used to compare various dosing regimens in order to optimise PK/PD target attainment.
RESULTS: The meropenem volume of distribution of the patient population was 54.95 L, while clearance started at 3.27 L/hour and increased by 0.91 L/hour with each 1 mL/s/1.73 m2 of estimated glomerular filtration rate. Meropenem clearance was also 0.31 L/hour higher in postoperative patients with central nervous system infection. Meropenem administration by continuous infusion showed a significantly higher probability of attaining the PK/PD target than a standard 30 min infusion (95.3% vs 49.5%).
CONCLUSIONS: A daily meropenem dose of 3 g, 6 g and 10.5 g administered by continuous infusion was shown to be accurate for patients with moderate to severe renal impairment, normal renal function to mild renal impairment and augmented renal clearance, respectively.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
European journal of hospital pharmacy : science and practice - 31(2024), 3 vom: 23. Apr., Seite 253-258 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Murínová, Irena [VerfasserIn] |
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| Links: |
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| Themen: |
Administration, intravenous |
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| Anmerkungen: |
Date Completed 24.04.2024 Date Revised 26.04.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/ejhpharm-2022-003535 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM348215045 |
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| 500 | |a Date Revised 26.04.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © European Association of Hospital Pharmacists 2024. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: The objective of this study was to develop a population pharmacokinetic model of meropenem in a heterogeneous population of patients with a serious bacterial infection in order to propose dosing optimisation leading to improved achievement of the pharmacokinetic/pharmacodynamic (PK/PD) target | ||
| 520 | |a METHODS: A total of 174 meropenem serum levels obtained from 144 patients during therapeutic drug monitoring were analysed using a non-linear mixed-effects modelling approach and Monte Carlo simulation was then used to compare various dosing regimens in order to optimise PK/PD target attainment | ||
| 520 | |a RESULTS: The meropenem volume of distribution of the patient population was 54.95 L, while clearance started at 3.27 L/hour and increased by 0.91 L/hour with each 1 mL/s/1.73 m2 of estimated glomerular filtration rate. Meropenem clearance was also 0.31 L/hour higher in postoperative patients with central nervous system infection. Meropenem administration by continuous infusion showed a significantly higher probability of attaining the PK/PD target than a standard 30 min infusion (95.3% vs 49.5%) | ||
| 520 | |a CONCLUSIONS: A daily meropenem dose of 3 g, 6 g and 10.5 g administered by continuous infusion was shown to be accurate for patients with moderate to severe renal impairment, normal renal function to mild renal impairment and augmented renal clearance, respectively | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a administration, intravenous | |
| 650 | 4 | |a critical care | |
| 650 | 4 | |a drug monitoring | |
| 650 | 4 | |a pharmacy service, hospital | |
| 650 | 4 | |a practice guideline | |
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| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Švidrnoch, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Gucký, Tomáš |e verfasserin |4 aut | |
| 700 | 1 | |a Řezáč, David |e verfasserin |4 aut | |
| 700 | 1 | |a Hlaváč, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Slanař, Ondřej |e verfasserin |4 aut | |
| 700 | 1 | |a Šíma, Martin |e verfasserin |4 aut | |
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