INTRODUCTION
Augmented Renal Clearance (ARC) is a common phenomenon among critically
ill patients [1-3]. The incidence of ARC, based on the studies
population and definition of ARC, reported from 14 to 80% [4, 5].
ARC refers to the enhanced renal elimination of solutes and is commonly
defined as Creatinine Clearance (CrCl) ≥130
ml/min/1.73m2 [4, 6]. Increase in the renal
clearance of drugs due to ARC, especially hydrophilic ones like
β-lactams, can lead to changes in the
Pharmacokinetic/Pharmacodynamic(PK/PD) properties [4, 7, 8] and
create sub-therapeutic concentrations of antibiotics as a major reason
of treatment failure in critically ill patients [5, 8-11]. Nowadays,
for enhancement of drug efficacy, interventions such as Therapeutic Drug
Monitoring (TDM) have been suggested to achieve the optimal
antimicrobial concentration [12].
Meropenem is a broad-spectrum β-lactam. Its bactericidal activity is
time-dependent, and minimum plasma concentration must be maintained
higher than the Minimum Inhibitory Concentration (MIC) for an adequate
percentage of time in the dosing interval (%ft >MIC) to
reach optimal efficacy [13-15]. According to this PD properties,
studies suggested prolonged infusion of meropenem rather than increasing
the dose to maximize efficacy and minimize concentration-related adverse
effects [16-18].
This study aimed to evaluate the PK/PD properties of meropenem in ARC
patients, receiving recommended doses as a 4-hr intermittent infusion.