Abstract
Background
The standard meropenem (MEPM) regimen allowed by insurance in Japan is 0.5 g two or
three times a day. Differences in dosages and administration schedules in Japan were
evaluated.
Methods
Patients with bacteremia for whom MEPM was used as the initial treatment at our institution
between 2016 and 2021 were included. We retrospectively investigated patients classified
into two groups: those treated according to severe infections (high-dose groupand
others (low-dose group). After propensity score matching, we compared the probability
of achieving free drug blood levels above the minimum inhibitory concentration (MIC)
in 24 h (%fT > MIC) and outcomes.
Results
The probability of 100% fT > MIC was significantly higher in the high-dose group (96.4% vs 74.5%, odds ratio
[OR] = 0.3, 95% confidence interval [CI] = 0.2–0.4, P = < 0.001). Regarding outcomes, the 30-day mortality rate was significantly lower
in the high-dose group (1.4% vs. 11.4%, OR = 8.0, 95% CI = 1.5–43.7, P = 0.019).
Conclusions
To improve outcomes in patients with bacteremia treated with MEPM, support for appropriate
antimicrobial use is necessary for compliance with the dosage and administration schedule
according to severe infections in initial treatment.
Keywords
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Article info
Publication history
Published online: April 22, 2023
Accepted:
April 10,
2023
Received in revised form:
April 4,
2023
Received:
January 18,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
