902. Interest of Routine Dosage of Meropenem in Difficult to Treat Infections
Session: Abstracts: Bacterial Infections
Saturday, October 23, 2010
Background:

Routine dosage of meropenem (MER) seems attractive to optimize the pharmacodynamic goal of > 40% time above MIC (40% T>MIC), particularly in difficult to treat infections and/or in ICU patients (pts).

Methods:

 We performed a retrospective study of  serum concentrations  of MER required by infectiologists (INF) and non infectiologists  (nonINF) physicians for bacteriological documented infections with MIC, during a 3.5 years period of time.

Results:

A total of 98 measurements were available in 54 pts with 56 episodes of infections(EPI). All were nosocomial infections (HAP and VAP 54% ; complicated intraabdominal infections 25% ;osteoarticular infections 7% ; others 14%) and 77% (43/56) occured in ICU. Dosages were ordered by INF in 65% (64/98), representing 45%  (25/56) of total EPI and 30% (13/43) of EPI in ICU. The number of dosages/ EPI was higher when asked by INF than by nonINF  (2.5 ± 1.7 vs 1.2 ± 0.45 respectively, p < 0.001). A single measurement (SM) occured in 66% (37/56) EPI : 40% for INF and 87% for nonINF, p< 0.005. In cases of SM, dosage was  not interpretable  in 33% (12/37) when asked by nonINF  and 0% when asked by INF, respectively, mainly due to wrong timing (before steady state in 82%). Infection was the cause of death in 13 pts: all of them had SM.  Among 44 interpretable EPI,  estimated > 40% T>MIC was achieved in 93%, but this was not correlated with clinical evolution, death, bacterial eradication or physicians requiring measurements (INF vs nonINF).

Conclusion:

SM of MER is related to unability to interpret dosages,  death and request from nonINF. A  closer collaboration is thus needed between INF and nonINF to improve the use of antibiotics measurements.


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Speakers:
Frédéric Frippiat, MD , Infectious Diseases, Centre Hospitalier Universitaire De Liège, Liège, Belgium
Ilham Bensahi, MD , Infectious Diseases, Centre Hospitalier Universitaire De Liège, Liège, Belgium
Raphael Denooz , Centre Hospitalier Universitaire, Liege, Belgium
Corinne Charlier , Toxicology, Centre Hospitalier Universitaire De Liège, Liège, Belgium
Sophie Vanbelle , Statistics, Centre Hospitalier Universitaire De Liège, Liege, Belgium
Pierre Damas, MD , ICU, Centre Hospitalier Universitaire De Liège, Liege, Belgium

Disclosures:

F. Frippiat, None

I. Bensahi, None

R. Denooz, None

C. Charlier, None

S. Vanbelle, None

P. Damas, None

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