ArticleAntimicrobial agents and chemotherapy2015
Meropenem population pharmacokinetics in critically ill patients with septic shock and continuous renal replacement therapy: influence of residual diuresis on dose requirements.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Population pharmacokinetics of imipenem in different populations for individualized dosing: a systematic review.Frontiers in pharmacology · 2025Pooled it
- Population Pharmacokinetic Meta-Analysis and Dosing Recommendation for Meropenem in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.Antimicrobial agents and chemotherapy · 2022Pooled it
- Scaling beta-lactam antimicrobial pharmacokinetics from early life to old age.British journal of clinical pharmacology · 2019Pooled it
- Comparative Plasma and Interstitial Tissue Fluid Pharmacokinetics of Meropenem Demonstrate the Need for Increasing Dose and Infusion Duration in Obese and Non-obese Patients.Clinical pharmacokinetics · 2022Trial
- Pharmacokinetics/pharmacodynamics of ceftazidime-avibactam in critically ill adult patients receiving continuous renal replacement therapy.Antimicrobial agents and chemotherapy · 2026Article
- Population Pharmacokinetic and Pharmacodynamic Analysis of Imipenem in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.Drug design, development and therapy · 2026Article
- Can Model-Informed Precision Dosing of Beta-Lactams in Critical Care Improve Clinical Outcomes?Chemotherapy · 2026Review
- Precision Dosing of Meropenem in a Neonate on CARPEDIEM Dialysis: A Grand Round.Therapeutic drug monitoring · 2025Article
- Population pharmacokinetics and pharmacodynamics of meropenem in critically ill patients with renal impairment or on continuous renal replacement therapy.European journal of clinical pharmacology · 2025Article
- Model-informed identification of optimised dosing strategies for meropenem in critically ill patients receiving SLEDD: an observational study.Infection · 2025Observational
- Meropenem and piperacillin/tazobactam optimised dosing regimens for critically ill patients receiving renal replacement therapy.Intensive care medicine · 2025Observational
- Improving Meropenem Quantification in a Compact SERS-Based Centrifugal Microfluidic Platform: Toward TDM of Antibiotics in ICU.Analytical chemistry · 2025Article
- Population Pharmacokinetics of Prolonged Infusion for Meropenem: Tailoring Dosing Recommendations for Chinese Critically Ill Patients on Continuous Renal Replacement Therapy with Consideration for Renal Function.Drug design, development and therapy · 2025Article
- Impact of Continuous Infusion Meropenem PK/PD Target Attainment on C-Reactive Protein Dynamics in Critically Ill Patients With Documented Gram-Negative Hospital-Acquired or Ventilator-Associated Pneumonia.Clinical pharmacokinetics · 2024Article
- Risk Factors Associated with Antibiotic Exposure Variability in Critically Ill Patients: A Systematic Review.Antibiotics (Basel, Switzerland) · 2024Review
- Association between Extended Meropenem Regimen and Achievement of Aggressive PK/PD in Patients Receiving Continuous Renal Replacement Therapy for Septic AKI.Antibiotics (Basel, Switzerland) · 2024Article
- How to use meropenem in pediatric patients undergoing CKRT? Integrated meropenem pharmacokinetic model for critically ill children.Antimicrobial agents and chemotherapy · 2024Article
- A New Dosing Frontier: Retrospective Assessment of Effluent Flow Rates and Residual Renal Function Among Critically Ill Patients Receiving Continuous Renal Replacement Therapy.Critical care explorations · 2024Article
- Meropenem extraction by ex vivo extracorporeal life support circuits.The journal of extra-corporeal technology · 2023Article
- Real-Time TDM-Based Expert Clinical Pharmacological Advice Program for Attaining Aggressive Pharmacokinetic/Pharmacodynamic Target of Continuous Infusion Meropenem in the Treatment of Critically Ill Patients with Documented Gram-Negative Infections Undergoing Continuous Veno-Venous Hemodiafiltration.Antibiotics (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Meropenem dosing in critically ill patients with septic shock and continuous renal replacement therapy (CRRT) is complex, with the recommended maintenance doses being 500 mg to 1,000 mg every 8 h (q8h) to every 12 h. This multicenter study aimed to describe the pharmacokinetics (PKs) of meropenem in this population to identify the sources of PK variability and to evaluate different dosing regimens to develop recommendations based on clinical parameters. Thirty patients with septic shock and CRRT receiving meropenem were enrolled (153 plasma samples were tested). A population PK model was developed with data from 24 patients and subsequently validated with data from 6 patients using NONMEM software (v.7.3). The final model was characterized by CL = 3.68 + 0.22 · (residual diuresis/100) and V = 33.00 · (weight/73)(2.07), where CL is total body clearance (in liters per hour), residual diuresis is the volume of residual diuresis (in milliliters per 24 h), and V is the apparent volume of distribution (in liters). CRRT intensity was not identified to be a CL modifier. Monte Carlo simulations showed that to maintain concentrations of the unbound fraction (fu ) of drug above the MIC of the bacteria for 40% of dosing interval T (referred to as 40% of the ƒ uT >MIC), a meropenem dose of 500 mg q8h as a bolus over 30 min would be sufficient regardless of the residual diuresis. If 100% of the ƒ uT >MIC was chosen as the target, oligoanuric patients would require 500 mg q8h as a bolus over 30 min for the treatment of susceptible bacteria (MIC < 2 mg/liter), while patients with preserved diuresis would require the same dose given as an infusion over 3 h. If bacteria with MICs close to the resistance breakpoint (2 to 4 mg/liter) were to be treated with meropenem, a dose of 500 mg every 6 h would be necessary: a bolus over 30 min for oligoanuric patients and an infusion over 3 h for patients with preserved diuresis. Our results suggest that residual diuresis may be an easy and inexpensive tool to help with titration of the meropenem dose and infusion time in this challenging population.
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