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.