Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patients
Objectives: To investigate the factors influencing imipenem/cilastatin (IMI) and meropenem (MEM) concentrations in critically ill adult patients and the role of these concentrations in the clinical outcome. Methods: Plasma trough concentrations of IMI and MEM were detected by high-performance liquid...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524000092 |
| _version_ | 1797249124161028096 |
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| author | Xi You Qing Dai Jing Hu Mingjie Yu Xiaowen Wang Bangbi Weng Lin Cheng Fengjun Sun |
| author_facet | Xi You Qing Dai Jing Hu Mingjie Yu Xiaowen Wang Bangbi Weng Lin Cheng Fengjun Sun |
| author_sort | Xi You |
| collection | DOAJ |
| description | Objectives: To investigate the factors influencing imipenem/cilastatin (IMI) and meropenem (MEM) concentrations in critically ill adult patients and the role of these concentrations in the clinical outcome. Methods: Plasma trough concentrations of IMI and MEM were detected by high-performance liquid chromatography. A target value of 100%-time above MIC was used for the drugs. Results: A total of 186 patients were included, with 87 receiving IMI and 99 receiving MEM. The percentages of patients reaching the target IMI and MEM concentrations were 44.8% and 38.4%, respectively. The proportions of patients infected with drug-resistant bacteria were 57.5% and 69.7% in the IMI group and MEM group, respectively. In the multivariate analysis, the risk factors for an IMI concentration that did not reach the target were infection with drug-resistant bacteria, and those for MEM were infection with drug-resistant bacteria, estimated glomerular filtration rate, and diabetes mellitus. A total of 47.1% of patients had good outcomes in the IMI cohort, and 38.1% of patients had good outcomes in the MEM cohort. The duration of mechanical ventilation and IMI concentration were associated with ICU stay in patients in the IMI cohort, while MEM concentration and severe pneumonia affected the clinical outcome of patients in the MEM cohort. Conclusion: Infection with drug-resistant bacteria is an important factor influencing whether IMI and MEM concentrations reach the target. Furthermore, IMI and MEM concentrations are associated with the clinical outcome, and elevated doses of IMI and MEM should be given to patients who are infected with drug-resistant bacteria. |
| first_indexed | 2024-03-08T00:48:39Z |
| format | Article |
| id | doaj.art-0accb3a138e24ea6a525574f982fd824 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-04-24T20:25:29Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-0accb3a138e24ea6a525574f982fd8242024-03-22T05:39:32ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-03-0136252259Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patientsXi You0Qing Dai1Jing Hu2Mingjie Yu3Xiaowen Wang4Bangbi Weng5Lin Cheng6Fengjun Sun7Department of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaCorresponding author at: Lin Cheng, Department of Pharmacy, The First Affiliated Hospital of Army Medical University, Gaotanyan Street #29, Shapingba, Chongqing 400038, China.; Department of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, ChinaObjectives: To investigate the factors influencing imipenem/cilastatin (IMI) and meropenem (MEM) concentrations in critically ill adult patients and the role of these concentrations in the clinical outcome. Methods: Plasma trough concentrations of IMI and MEM were detected by high-performance liquid chromatography. A target value of 100%-time above MIC was used for the drugs. Results: A total of 186 patients were included, with 87 receiving IMI and 99 receiving MEM. The percentages of patients reaching the target IMI and MEM concentrations were 44.8% and 38.4%, respectively. The proportions of patients infected with drug-resistant bacteria were 57.5% and 69.7% in the IMI group and MEM group, respectively. In the multivariate analysis, the risk factors for an IMI concentration that did not reach the target were infection with drug-resistant bacteria, and those for MEM were infection with drug-resistant bacteria, estimated glomerular filtration rate, and diabetes mellitus. A total of 47.1% of patients had good outcomes in the IMI cohort, and 38.1% of patients had good outcomes in the MEM cohort. The duration of mechanical ventilation and IMI concentration were associated with ICU stay in patients in the IMI cohort, while MEM concentration and severe pneumonia affected the clinical outcome of patients in the MEM cohort. Conclusion: Infection with drug-resistant bacteria is an important factor influencing whether IMI and MEM concentrations reach the target. Furthermore, IMI and MEM concentrations are associated with the clinical outcome, and elevated doses of IMI and MEM should be given to patients who are infected with drug-resistant bacteria.http://www.sciencedirect.com/science/article/pii/S2213716524000092Imipenem/cilastatinMeropenemTherapeutic drug monitoringDrug resistanceClinical outcome |
| spellingShingle | Xi You Qing Dai Jing Hu Mingjie Yu Xiaowen Wang Bangbi Weng Lin Cheng Fengjun Sun Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patients Journal of Global Antimicrobial Resistance Imipenem/cilastatin Meropenem Therapeutic drug monitoring Drug resistance Clinical outcome |
| title | Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patients |
| title_full | Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patients |
| title_fullStr | Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patients |
| title_full_unstemmed | Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patients |
| title_short | Therapeutic drug monitoring of imipenem/cilastatin and meropenem in critically ill adult patients |
| title_sort | therapeutic drug monitoring of imipenem cilastatin and meropenem in critically ill adult patients |
| topic | Imipenem/cilastatin Meropenem Therapeutic drug monitoring Drug resistance Clinical outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2213716524000092 |
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