Observational studyEuropean journal of clinical pharmacology2019
Evaluation of a non-parametric modelling for meropenem in critically ill patients using Monte Carlo simulation.
Observational study in European journal of clinical pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed.
- Predictive accuracy of population meropenem models in critically ill pneumonia patients.Antimicrobial agents and chemotherapy · 2026Article
- Covariates in population pharmacokinetic studies of critically ill adults receiving β-lactam antimicrobials: a systematic review and narrative synthesis.JAC-antimicrobial resistance · 2024Review
- A Systematic Review on Antimicrobial Pharmacokinetic Differences between Asian and Non-Asian Adult Populations.Antibiotics (Basel, Switzerland) · 2023Review
- Meropenem Pharmacokinetics and Target Attainment in Critically Ill Patients.Infection and drug resistance · 2023Article
- Meropenem Target Attainment and Population Pharmacokinetics in Critically Ill Septic Patients with Preserved or Increased Renal Function.Infection and drug resistance · 2022Article
- The Evaluation of Meropenem Dosing Regimens Against ESBL-ProducingInfection and drug resistance · 2022Article
- Clinical pharmacokinetics of 3-h extended infusion of meropenem in adult patients with severe sepsis and septic shock: implications for empirical therapy against Gram-negative bacteria.Annals of intensive care · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
purposeIn critically ill patients treated with meropenem, the proposed pharmacokinetics/pharmacodynamics (PK/PD) efficacy index is to keep the free drug concentration 4-5 times above the minimum inhibitory concentration (MIC) of the germ isolated, for 100% of the interval regimen. The objectives were to design a population pharmacokinetics model for meropenem in critically ill patients and to evaluate different dosage schemes that achieve the optimal PK/PD objectives.
methodsThis retrospective, observational, single-centre study included 80 critically ill patients (154 samples) treated with meropenem between May 2011 and December 2017. Patient data, concentrations, treatment and bacteriological variables were collected from electronic medical records. Total and free concentrations of meropenem were modelled in Pmetrics. Monte Carlo simulations were performed to assess the probability of achieving the PK/PD target for different dosage regimens. For patients with available data, the number of patients with a free concentration 4 times higher or lower than the observed MIC for the P. aeruginosa and E. coli was investigated.
resultsA one-compartment model with first-order elimination adequately described serum total and free meropenem concentrations. The only variable that significantly influenced the elimination constant of meropenem was the creatinine clearance (CLcr) calculated using the CKD-EPI formula. The highest probability of achieving the pharmacodynamic objective was with 3-h infusion dosage regimens. Sixty percent and 89% of patients attained a free drug concentration 4 times above the MIC for P. aeruginosa and E. coli respectively.
conclusionsThis study proposed different dosing regimens depending on renal clearance strata and the MIC of the germ targeted.
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