Optimization of meropenem dosing regimens in critically ill patients with augmented renal clearance DOI Creative Commons
Jinfeng Luo, Jing Liu,

Hongfu Lin

et al.

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: May 9, 2025

The pharmacokinetics of meropenem are significantly altered in patients with augmented renal clearance (ARC), resulting suboptimal plasma concentrations. objective this study is to investigate the efficacy different regimens critically ill ARC. To end, Monte Carlo simulations were conducted. probability target attainment (PTA) and cumulative fraction response (CFR) evaluated consideration minimal inhibitory concentration (MIC) breakpoint according Clinical Laboratory Standards Institute (CLSI). findings demonstrate that administered at a dosage 2 g every 8 h (q8 h) 2/3 ARC [creatinine (CrCL) 140–200 mL/min] results ≥ 90% PTA (100% f T > MIC) for lower MICs (≤ mg/L). However, higher (4–8 mg/L), administration intensified (2 q8 4/6 or continuous infusion) was necessary. CFR analysis confirmed Klebsiella pneumoniae 2–6 infusion, but not Acinetobacter baumannii Pseudomonas aeruginosa , regardless regimen. For resistant (4 < MIC ≤ 8), prolonged (4–6 infusions recommended. alternative combination therapies advised due insufficient PK/PD monotherapy. emphasize importance individualized dosing strategies patients, considering meropenem’s distinctive characteristics, pathogen’s MIC, function, order effectively manage Gram-negative infections while optimizing clinical outcomes.

Language: Английский

Optimization of meropenem dosing regimens in critically ill patients with augmented renal clearance DOI Creative Commons
Jinfeng Luo, Jing Liu,

Hongfu Lin

et al.

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: May 9, 2025

The pharmacokinetics of meropenem are significantly altered in patients with augmented renal clearance (ARC), resulting suboptimal plasma concentrations. objective this study is to investigate the efficacy different regimens critically ill ARC. To end, Monte Carlo simulations were conducted. probability target attainment (PTA) and cumulative fraction response (CFR) evaluated consideration minimal inhibitory concentration (MIC) breakpoint according Clinical Laboratory Standards Institute (CLSI). findings demonstrate that administered at a dosage 2 g every 8 h (q8 h) 2/3 ARC [creatinine (CrCL) 140–200 mL/min] results ≥ 90% PTA (100% f T > MIC) for lower MICs (≤ mg/L). However, higher (4–8 mg/L), administration intensified (2 q8 4/6 or continuous infusion) was necessary. CFR analysis confirmed Klebsiella pneumoniae 2–6 infusion, but not Acinetobacter baumannii Pseudomonas aeruginosa , regardless regimen. For resistant (4 < MIC ≤ 8), prolonged (4–6 infusions recommended. alternative combination therapies advised due insufficient PK/PD monotherapy. emphasize importance individualized dosing strategies patients, considering meropenem’s distinctive characteristics, pathogen’s MIC, function, order effectively manage Gram-negative infections while optimizing clinical outcomes.

Language: Английский

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