Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomised controlled trial of continuous infusion versus intermittent bolus administration

Jamal, Janattul-Ain, Mat-Nor, Mohd-Basri, Mohamad-Nor, Fariz-Safhan, Udy, Andrew A., Wallis, Steven C., Lipman, Jeffrey and Roberts, Jason A. (2015) Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomised controlled trial of continuous infusion versus intermittent bolus administration. International Journal of Antimicrobial Agents, 45 1: 41-45. doi:10.1016/j.ijantimicag.2014.09.009


Author Jamal, Janattul-Ain
Mat-Nor, Mohd-Basri
Mohamad-Nor, Fariz-Safhan
Udy, Andrew A.
Wallis, Steven C.
Lipman, Jeffrey
Roberts, Jason A.
Title Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomised controlled trial of continuous infusion versus intermittent bolus administration
Journal name International Journal of Antimicrobial Agents   Check publisher's open access policy
ISSN 0924-8579
1872-7913
Publication date 2015
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.ijantimicag.2014.09.009
Volume 45
Issue 1
Start page 41
End page 45
Total pages 5
Place of publication Amsterdam, The Netherlands
Publisher Elsevier
Collection year 2015
Language eng
Formatted abstract
The objective of this study was to describe the pharmacokinetics of meropenem, administered by continuous infusion (CI) or intermittent bolus (IB), in critically ill patients receiving continuous venovenous haemofiltration (CVVH) and to evaluate the frequency of pharmacokinetic/pharmacodynamic target attainment with each dosing strategy. This was a prospective, randomised controlled trial in critically ill patients receiving CVVH and administered meropenem by CI or IB. Serial meropenem concentrations in plasma and ultrafiltrate were measured after administration of a standard total daily dose (4 g/day on Day 1, followed by 3 g/day thereafter) on two occasions during antibiotic therapy. Meropenem pharmacokinetic parameters were calculated using a non-compartmental approach. Sixteen critically ill patients receiving CVVH concurrently treated with meropenem were randomised to CI (n = 8) or IB dosing (n = 8). IB administration resulted in higher maximum concentrations (Cmax) [64.7 (58.9–80.3) and 64.8 (48.5–81.8) mg/L, respectively] on both sampling occasions compared with CI (P < 0.01 and P = 0.04, respectively). CI resulted in a higher meropenem steady-state concentration (Css) on occasion 1 [26.0 (24.5–41.6) mg/L] compared with the minimum concentration (Cmin) observed for IB patients [17.0 (15.7–19.8) mg/L; P < 0.01]. CVVH contributed to ca. 50% of meropenem total clearance in these patients. The administered meropenem doses resulted in plasma drug concentrations that were >4× the targeted susceptibility breakpoint (2 mg/L) for 100% of the dosing interval, for both groups, on both occasions. CI could be an alternative to IB for meropenem administration in critically ill patients receiving CVVH.
Keyword Continuous infusion
Intensive care
Meropenem
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
School of Pharmacy Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 6 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 6 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 16 Dec 2014, 01:26:14 EST by System User on behalf of School of Medicine