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Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study

This single-center historical cohort study investigated the effectiveness and safety of extended infusion (EI) compared with short-term infusion (STI) of meropenem in neonatal sepsis. Patient electronic health records from Peking University Third Hospital (1 December 2011–1 April 2021) were screened...

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Autores principales: Cao, Guangna, Zhou, Pengxiang, Zhang, Hua, Sun, Bangkai, Tong, Xiaomei, Xing, Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944670/
https://www.ncbi.nlm.nih.gov/pubmed/35326804
http://dx.doi.org/10.3390/antibiotics11030341
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author Cao, Guangna
Zhou, Pengxiang
Zhang, Hua
Sun, Bangkai
Tong, Xiaomei
Xing, Yan
author_facet Cao, Guangna
Zhou, Pengxiang
Zhang, Hua
Sun, Bangkai
Tong, Xiaomei
Xing, Yan
author_sort Cao, Guangna
collection PubMed
description This single-center historical cohort study investigated the effectiveness and safety of extended infusion (EI) compared with short-term infusion (STI) of meropenem in neonatal sepsis. Patient electronic health records from Peking University Third Hospital (1 December 2011–1 April 2021) were screened. Neonates diagnosed with sepsis and treated with meropenem in the neonatal intensive care unit were included (256 patients) as STI (0.5 h, 129 patients) and EI (2–3 h, 127 patients) groups. Three-day clinical effectiveness and three-day microbial clearance were considered the main outcomes. Univariate and multivariate analyses were performed. Baseline characteristics were similar in both groups. EI of meropenem was associated with a significantly higher 3-day clinical effectiveness rate (0.335 (0.180, 0.623), p = 0.001) and 3-day microbial clearance (4.127 (1.235, 13.784), p = 0.021) than STI, with comparable safety. Subgroup analyses showed that neonates with very low birth weight benefited from EI in terms of 3-day clinical effectiveness rate (75.6% versus 56.6%, p = 0.007), with no significant difference in the 3-day clinical effectiveness (85.1% versus 78.3%, p = 0.325) and microbial clearance (6% versus 5%, p > 0.999) rates between 3 h and 2 h infusions. Thus, EI of meropenem may be associated with better effectiveness and comparable safety in treating neonatal sepsis than STI. Nonetheless, historically analyzed safety evaluation might be biased, and these findings need confirmation in randomized controlled trials of larger sample sizes.
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spelling pubmed-89446702022-03-25 Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study Cao, Guangna Zhou, Pengxiang Zhang, Hua Sun, Bangkai Tong, Xiaomei Xing, Yan Antibiotics (Basel) Article This single-center historical cohort study investigated the effectiveness and safety of extended infusion (EI) compared with short-term infusion (STI) of meropenem in neonatal sepsis. Patient electronic health records from Peking University Third Hospital (1 December 2011–1 April 2021) were screened. Neonates diagnosed with sepsis and treated with meropenem in the neonatal intensive care unit were included (256 patients) as STI (0.5 h, 129 patients) and EI (2–3 h, 127 patients) groups. Three-day clinical effectiveness and three-day microbial clearance were considered the main outcomes. Univariate and multivariate analyses were performed. Baseline characteristics were similar in both groups. EI of meropenem was associated with a significantly higher 3-day clinical effectiveness rate (0.335 (0.180, 0.623), p = 0.001) and 3-day microbial clearance (4.127 (1.235, 13.784), p = 0.021) than STI, with comparable safety. Subgroup analyses showed that neonates with very low birth weight benefited from EI in terms of 3-day clinical effectiveness rate (75.6% versus 56.6%, p = 0.007), with no significant difference in the 3-day clinical effectiveness (85.1% versus 78.3%, p = 0.325) and microbial clearance (6% versus 5%, p > 0.999) rates between 3 h and 2 h infusions. Thus, EI of meropenem may be associated with better effectiveness and comparable safety in treating neonatal sepsis than STI. Nonetheless, historically analyzed safety evaluation might be biased, and these findings need confirmation in randomized controlled trials of larger sample sizes. MDPI 2022-03-04 /pmc/articles/PMC8944670/ /pubmed/35326804 http://dx.doi.org/10.3390/antibiotics11030341 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cao, Guangna
Zhou, Pengxiang
Zhang, Hua
Sun, Bangkai
Tong, Xiaomei
Xing, Yan
Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study
title Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study
title_full Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study
title_fullStr Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study
title_full_unstemmed Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study
title_short Extended Infusion of Meropenem in Neonatal Sepsis: A Historical Cohort Study
title_sort extended infusion of meropenem in neonatal sepsis: a historical cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944670/
https://www.ncbi.nlm.nih.gov/pubmed/35326804
http://dx.doi.org/10.3390/antibiotics11030341
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