Continuous versus Intermittent Use of Meropenem in Septic Critically Ill Patients: A Randomized Controlled Trail | ||
| Benha Medical Journal | ||
| Article 4, Volume 41, Issue 2, May and June 2024, Pages 38-48 PDF (627.92 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/bmfj.2023.247556.1949 | ||
| Authors | ||
| Saad Ibrahim Saad1; Bsem Mofreh Aglan2; Eslam Ali Shaboob3; Hossam Helmy Abdelghany* 4 | ||
| 1Professor of Anesthesiology, Faculty of Medicine, Benha University | ||
| 2Assistant Professor of Cardiothoracic Surgery, Faculty of Medicine, Benha University | ||
| 3Lecturer of Anesthesiology, Faculty of Medicine, Benha University | ||
| 4Department of critical care medicine Faculty of Medicine - Benha University | ||
| Abstract | ||
| Background: Meropenem is commonly used in the treatment of critically ill patients with sepsis. However, the optimal dosing regimen remains a subject of debate. This study aimed to compare the pharmacokinetic, clinical, and bacteriological efficacies of continuous infusion of meropenem versus traditional intermittent administration in critically ill patients with sepsis, and to evaluate the safety of both dosing regimens. Methods: This prospective randomized controlled trial was conducted on critically ill patients diagnosed with sepsis and admitted to the ICU. Patients were randomly assigned to either the continuous infusion group (n=30) or the intermittent intravenous group (n=30). Clinical parameters, laboratory data, and clinical outcomes were recorded. Microbiological outcomes, including microbiological eradication and superinfection, were assessed. Pharmacokinetic analysis was performed to evaluate drug concentrations. Results: The superinfection rate (requiring other antibiotics) was lower in the continuous group (3.3%) compared to 16.7% in intermittent group. The mean total fluid infusion in the first 24hr was 4190 ml in the continuous group compared to 4336 ml in the intermittent group. The mean length of ICU stay was 10.10 ± 6.12 days in the continuous group compared to 11.60 ± 5.55 days in the intermittent group. A significantly lower mean duration of meropenem treatment (9.93 days) was associated with continuous group compared to 11.53 days in intermittent group. Mortality rate was lower in the continuous group (26.7%) compared to intermittent group (40%). Conclusion: Continuous infusion of meropenem demonstrated superior clinical and bacteriological outcomes in critically ill septic patients compared to intermittent administration. | ||
| Keywords | ||
| Sepsis; Meropenem; Continuous Infusion; Intermitten | ||
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