Training a Drug to Do New Tricks: Insights on Stability of Meropenem Administered as a Continuous Infusion
| Autor: | Samuel J. Borgert, Kenneth P. Klinker, Kayihura Manigaba, Charles A. Peloquin, Jessica Cope, Veena Venugopalan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Drug Continuous infusion medicine.drug_class therapeutic drug monitoring media_common.quotation_subject 030106 microbiology Antibiotics lcsh:QR1-502 Meropenem lcsh:Microbiology 03 medical and health sciences 0302 clinical medicine meropenem medicine polycyclic compounds Dosing Original Research media_common medicine.diagnostic_test business.industry Antibiotic exposure 030208 emergency & critical care medicine continuous infusion antibiotic exposure Therapeutic drug monitoring Anesthesia business Drug stability medicine.drug |
| Zdroj: | Microbiology Insights, Vol 11 (2018) Microbiology Insights |
| ISSN: | 1178-6361 |
| Popis: | Background: The antibiotic armamentarium used to combat multi-drug resistant organisms (MDROs) include carbapenems. Continuous infusion (CI) dosing is frequently employed to maximize beta-lactam efficacy; however, use of meropenem CI has been limited due to concerns with product instability. Objective: The primary objective of this study was to quantify meropenem serum concentrations to reflect drug stability when administered as CI over 8- or 12-h exchanges. In addition, a stability experiment was performed to further establish meropenem integrity over 12 h. The secondary objectives were to assess the ability of meropenem to achieve target pharmacokinetic/pharmacodynamic (PK/PD) exposures relative to the minimum inhibitory concentration (MIC) of the pathogen, and to determine clinical cure. Methods: This was a retrospective, observational study on use of CI meropenem (infused either over 8- or 12- h) at a 1% concentration. The stability experiment was conducted on 1% meropenem at room temperature. Results: In 22 patients, a median meropenem daily dose of 6 g/day (range 2-6 g/day) resulted in a median serum concentration of 17.8 mg/L (interquartile range, 9.3-27.8 mg/L). In 95% of cases, meropenem delivered as CI resulted in free drug concentrations at or above the MIC of the pathogen for the entire dosing interval. Clinical cure was achieved in 80% of patients included in this review. The stability experiment revealed negligible drug degradation at the end of the 12-h dosing interval. Conclusions: The data from this study provides compelling evidence for the use of meropenem as CI utilizing either a 12- or 8-h exchange process. |
| Databáze: | OpenAIRE |
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