A Retrospective Analysis of Intravenous Push versus Extended Infusion Meropenem in Critically Ill Patients

Antibiotics Pub Date : 2024-09-02 DOI:10.3390/antibiotics13090835

Emory G. Johnson, Kayla Maki Ortiz, David T. Adams, Satwinder Kaur, Andrew C. Faust, Hui Yang, Carlos A. Alvarez, Ronald G. Hall

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Abstract

Meropenem is a broad-spectrum antibiotic used for the treatment of multi-drug-resistant infections. Due to its pharmacokinetic profile, meropenem’s activity is optimized by maintaining a specific time the serum concentration remains above the minimum inhibitory concentration (MIC) via extended infusion (EI), continuous infusion, or intermittent infusion dosing strategies. The available literature varies regarding the superiority of these dosing strategies. This study’s primary objective was to determine the difference in time to clinical stabilization between intravenous push (IVP) and EI administration. We performed a retrospective pilot cohort study of 100 critically ill patients who received meropenem by IVP (n = 50) or EI (n = 50) during their intensive care unit (ICU) admission. There was no statistically significant difference in the overall achievement of clinical stabilization between IVP and EI (48% vs. 44%, p = 0.17). However, the median time to clinical stability was shorter for the EI group (20.4 vs. 66.2 h, p = 0.01). EI administration was associated with shorter hospital (13 vs. 17 days; p = 0.05) and ICU (6 vs. 9 days; p = 0.02) lengths of stay. Although we did not find a statistically significant difference in the overall time to clinical stabilization, the results of this pilot study suggest that EI administration may produce quicker clinical resolutions than IVP.

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重症患者静脉推注与延长输注美罗培南的回顾性分析

美罗培南是一种广谱抗生素，用于治疗多重耐药感染。由于其药代动力学特征，美罗培南的活性可通过延长输注（EI）、连续输注或间歇输注等给药策略，在特定时间内使血清浓度保持在最低抑菌浓度（MIC）以上。关于这些给药策略的优劣，现有文献说法不一。本研究的主要目的是确定静脉推注（IVP）和 EI 给药在临床稳定时间上的差异。我们对 100 名重症患者进行了回顾性试点队列研究，这些患者在入住重症监护病房（ICU）期间通过静脉推注（50 人）或电子输入（50 人）接受了美罗培南治疗。IVP和EI在总体临床稳定率上没有明显的统计学差异（48%对44%，P = 0.17）。不过，EI 组临床稳定的中位时间更短（20.4 小时对 66.2 小时，p = 0.01）。使用 EI 可缩短住院时间（13 天 vs. 17 天；p = 0.05）和重症监护室住院时间（6 天 vs. 9 天；p = 0.02）。虽然我们在临床稳定的总体时间上没有发现显著的统计学差异，但这项试点研究的结果表明，与静脉输液相比，使用 EI 可以更快地解决临床问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Antibiotics

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