RESULTS
From a total of 819 critically ill patients who admitted to the ICU from
July 23, 2018, to March 19, 2019, 79 patients were ARC positive,
according to 12-hr CrCl, and 16 subjects received meropenem. Twelve
patients received meropenem with a dose of 1g every 8 hours (group 1),
and the remaining four subjects received 2g every 8 hours (group 2).
During the treatment period, the dose of meropenem increased from 1g
every 8 hours to 2g every 8 hours, according to their physician
decision, for two patients in group 1. We gathered blood samples of them
after achieving steady-state based on drug half-life. Overall we
collected 18 paired samples (peak and trough concentrations) for
analyzes that 12 samples were for group 1, and 6 samples were for group
2. We were detailed data in Figure 1.
Baseline characteristics including age, sex, Ideal Body Weight (IBW),
ICU diagnosis on admission based on International Classification of
Diseases-10 (ICD10) codes, Sequential Organ Failure Assessment (SOFA),
ARC and ARCTIC score, 12-hr CrCl were recorded for participants. There
were statistically significant differences in sex, ICU diagnosis and
ARCTIC score between two groups (p= 0.001, 0.017, 0.030, respectively).
The results are shown in Table2.
The mean ± SD of the PK parameters are shown in Table 3 and Figure 2.
There were no statistically significant differences in the parameters
between the two groups, except Cpeak. The peak concentrations was
significantly lower in group 1 than group 2 (mean ± SD: 5.95 ± 3.39
µg/mL vs 11.93 ± 4.18 µg/mL, respectively); t (16) = - 3.273, p =
0.005 (Figure 2B). The mean ± SD of trough concentrations was 1.32 ±
1.01 µg/mL in group 1 and 2.37 ± 2.08 µg/mL in group 2 (Figure 2A).
In 13 out of 18 samples (72%), trough level was less than <2
µg/mL (sub-therapeutic) that 10 of them were in group 1 (83% of 12
trough concentrations) and 3 of them were in group 2 (50% of 6 trough
concentrations)(Figure 3A). ft>MIC ≥ 50% was achieved in
10 patients of group 1(83.3%) and 5 patients of group 2 (83.3%)
whereas 2 patients of group 1 (16.6%) and 2 patients of group 2
(33.3%) had ft> MIC= 100% (Figure 3B).