Software- and TDM-guided dosing of Meropenem promises high rates of target attainment in critically Ill patients
Various studies have reported insufficient beta-lactam concentrations in critically ill patients. The optimal dosing strategy for beta-lactams in critically ill patients, particularly in septic patients, is an ongoing matter of discussion. This retrospective study aimed to evaluate the success of so...
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| Hauptverfasser: | , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2023
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| In: |
Antibiotics
Year: 2023, Jahrgang: 12, Heft: 7, Pages: 1-14 |
| ISSN: | 2079-6382 |
| DOI: | 10.3390/antibiotics12071112 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.3390/antibiotics12071112 Verlag, kostenfrei, Volltext: https://www.mdpi.com/2079-6382/12/7/1112 
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| Verfasserangaben: | Ute Chiriac, Daniel Richter, Otto R. Frey, Anka C. Röhr, Sophia Helbig, Stefan Hagel, Uwe Liebchen, Markus A. Weigand and Alexander Brinkmann |
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| 520 | |a Various studies have reported insufficient beta-lactam concentrations in critically ill patients. The optimal dosing strategy for beta-lactams in critically ill patients, particularly in septic patients, is an ongoing matter of discussion. This retrospective study aimed to evaluate the success of software-guided empiric meropenem dosing (CADDy, Calculator to Approximate Drug-Dosing in Dialysis) with subsequent routine meropenem measurements and expert clinical pharmacological interpretations. Adequate therapeutic drug exposure was defined as concentrations of 8-16 mg/L, whereas concentrations of 16-24 mg/L were defined as moderately high and concentrations >24 mg/L as potentially harmful. A total of 91 patients received meropenem as a continuous infusion (229 serum concentrations), of whom 60% achieved 8-16 mg/L, 23% achieved 16-24 mg/L, and 10% achieved unnecessarily high and potentially harmful meropenem concentrations >24 mg/L in the first 48 h using the dosing software. No patient showed concentrations <2 mg/L using the dosing software in the first 48 h. With a subsequent TDM-guided dose adjustment, therapeutic drug exposure was significantly (p ≤ 0.05) enhanced to 70%. No patient had meropenem concentrations >24 mg/L with TDM-guided dose adjustments. The combined use of dosing software and consecutive TDM promised a high rate of adequate therapeutic drug exposures of meropenem in patients with sepsis and septic shock. | ||
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