ArticleBritish journal of clinical pharmacology2026
Relationship between continuous infusion meropenem PK/PD target attainment and C-reactive protein dynamics in onco-haematologic patients with febrile neutropenia.
Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Relationship between continuous infusion meropenem PK/PD target attainment and C-reactive protein dynamics in onco-haematologic patients with febrile neutropenia.British journal of clinical pharmacology · 2026Article
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8 authors.
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Abstract
aimMeropenem is a second-line antimicrobial agent in the treatment of febrile neutropenia in onco-haematological patients. A population pharmacokinetic/pharmacodynamic (PK/PD) analysis for assessing the relationship between meropenem exposure and C-reactive protein (C-RP) over time was conducted.
methodsNon-linear mixed-effect modelling was used to fit meropenem and C-RP concentrations. Monte Carlo simulations were conducted to assess median percentage reduction of C-RP from baseline associated with continuous infusion meropenem dosing, ensuring optimal PK/PD target attainment against Pseudomonas aeruginosa and Enterobacterales, namely, 100%t
resultsA total of 141 patients were included in the analysis. A one-compartment model with estimated glomerular filtration rate as a covariate on drug clearance well-described meropenem pharmacokinetics. An indirect turnover maximum inhibition model was used to capture C-RP dynamics. Patients with C-RP Day 4/baseline ratio of <0.4 (fast response), between 0.4 and 0.8 (slow response) and >0.8 (no response) were 8.5%, 15.6% and 75.9%, respectively. Regression analysis showed that patients with fast and slow response patterns were associated with favourable clinical outcomes. Simulations showed that rapid and slow pattern patients reached C-RP reduction >90% from baseline at Days 6 and 10, respectively. No response pattern had C-RP peaking at Day 3 and eventually gradually reducing within 2 weeks.
conclusionDespite optimal meropenem PK/PD target attainment, C-RP decreases in no more than one-fourth of onco-haematological patients during the first 2 weeks of treatment. Among no-response patients, C-RP should be associated with other biomarkers to discriminate subjects with favourable clinical outcome.
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