Meropenem for Patients with Sepsis: Does Infusion Schedule Matter?

Compared with intermittent administration, continuous infusion of meropenem in patients with sepsis did not confer survival benefit or reduce risk for new antimicrobial resistance.

Beta-lactam antibiotic activity is time dependent, with efficacy related to duration within the dosing interval that concentrations are above the minimum inhibitory concentration (T>MIC) of the targeted pathogen. Continuous administration strategies are designed to maximize T>MIC for a given daily dose, potentially improving efficacy.

In the Continuous vs Intermittent Meropenem Administration in Critically Ill Patients with Sepsis (MERCY) trial, Monti et al. enrolled 607 patients with sepsis or septic shock (mean age, 64; 33% female) who were randomized 1:1 to receive meropenem continuously (3g/24 hours) or intermittently (1g every 8 hours). Immunosuppressed patients were excluded. The primary endpoint was a composite of all-cause mortality …

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases