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C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem

This prospective study aimed to explore the determinants of meropenem trough concentration (C(trough)) in patients with bacterial pneumonia and to investigate the association between its concentration and efficacy. From January 2019 to December 2019, patients with pulmonary infections were prospecti...

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Autores principales: Zhao, Yichang, Xiao, Chenlin, Hou, Jingjing, Wu, Jiamin, Xiao, Yiwen, Zhang, Bikui, Sandaradura, Indy, Luo, Hong, Li, Jinhua, Yan, Miao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137711/
https://www.ncbi.nlm.nih.gov/pubmed/35625314
http://dx.doi.org/10.3390/antibiotics11050670
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author Zhao, Yichang
Xiao, Chenlin
Hou, Jingjing
Wu, Jiamin
Xiao, Yiwen
Zhang, Bikui
Sandaradura, Indy
Luo, Hong
Li, Jinhua
Yan, Miao
author_facet Zhao, Yichang
Xiao, Chenlin
Hou, Jingjing
Wu, Jiamin
Xiao, Yiwen
Zhang, Bikui
Sandaradura, Indy
Luo, Hong
Li, Jinhua
Yan, Miao
author_sort Zhao, Yichang
collection PubMed
description This prospective study aimed to explore the determinants of meropenem trough concentration (C(trough)) in patients with bacterial pneumonia and to investigate the association between its concentration and efficacy. From January 2019 to December 2019, patients with pulmonary infections were prospectively enrolled from the intensive care unit. Factors affecting the meropenem trough concentration were analyzed, and a multiple linear regression model was constructed. Logistic regression analyses were used to investigate the relationship between C(trough) and clinical efficacy. A total of 64 patients were enrolled, in whom 210 meropenem concentrations were measured. Of the total, 60.9% (39/64) were considered clinically successful after treatment. C(trough) may increase with increased blood urea nitrogen, albumin, and concomitant antifungal use. By contrast, concentration may decrease with increased endogenous creatinine clearance rate. Six variables, including C(trough)/minimum inhibitory concentration (MIC) > 4, were associated with the efficacy of meropenem. There was an independent correlation between C(trough)/MIC > 4 and efficacy after fully adjusting for confounding factors. Based upon renal function indexes, it is possible to predict changes in meropenem concentration and adjust the dosage precisely and individually. C(trough)/MIC > 4 is a potential instrument to predict successful treatment with meropenem.
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spelling pubmed-91377112022-05-28 C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem Zhao, Yichang Xiao, Chenlin Hou, Jingjing Wu, Jiamin Xiao, Yiwen Zhang, Bikui Sandaradura, Indy Luo, Hong Li, Jinhua Yan, Miao Antibiotics (Basel) Article This prospective study aimed to explore the determinants of meropenem trough concentration (C(trough)) in patients with bacterial pneumonia and to investigate the association between its concentration and efficacy. From January 2019 to December 2019, patients with pulmonary infections were prospectively enrolled from the intensive care unit. Factors affecting the meropenem trough concentration were analyzed, and a multiple linear regression model was constructed. Logistic regression analyses were used to investigate the relationship between C(trough) and clinical efficacy. A total of 64 patients were enrolled, in whom 210 meropenem concentrations were measured. Of the total, 60.9% (39/64) were considered clinically successful after treatment. C(trough) may increase with increased blood urea nitrogen, albumin, and concomitant antifungal use. By contrast, concentration may decrease with increased endogenous creatinine clearance rate. Six variables, including C(trough)/minimum inhibitory concentration (MIC) > 4, were associated with the efficacy of meropenem. There was an independent correlation between C(trough)/MIC > 4 and efficacy after fully adjusting for confounding factors. Based upon renal function indexes, it is possible to predict changes in meropenem concentration and adjust the dosage precisely and individually. C(trough)/MIC > 4 is a potential instrument to predict successful treatment with meropenem. MDPI 2022-05-16 /pmc/articles/PMC9137711/ /pubmed/35625314 http://dx.doi.org/10.3390/antibiotics11050670 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
Zhao, Yichang
Xiao, Chenlin
Hou, Jingjing
Wu, Jiamin
Xiao, Yiwen
Zhang, Bikui
Sandaradura, Indy
Luo, Hong
Li, Jinhua
Yan, Miao
C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem
title C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem
title_full C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem
title_fullStr C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem
title_full_unstemmed C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem
title_short C/MIC > 4: A Potential Instrument to Predict the Efficacy of Meropenem
title_sort c/mic > 4: a potential instrument to predict the efficacy of meropenem
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137711/
https://www.ncbi.nlm.nih.gov/pubmed/35625314
http://dx.doi.org/10.3390/antibiotics11050670
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