291. Clinical Outcomes of Extended Infusion Doripenem in the ICU: Experience at a Community, Teaching Hospital
Session: Poster Abstract Session: Antimicrobial Therapy: Clinical Studies
Friday, October 21, 2011
Room: Poster Hall B1
Background: Antimicrobial treatment has become extremely challenging due to emerging antibiotic resistance.  Optimizing the pharmacokinetics and pharmacodynamics of antimicrobial agents is crucial to improve outcomes.   For doripenem the goal is to achieve concentration of free drug that exceeds the minimum inhibitory concentration (MIC) for at least 40% of the dosing interval.  The promising strategy to optimize the pharmacodynamic profile of doripenem is an extended infusion (over 4 hours).  In this study, we compared the intermittent infusion (over 0.5 hours) and extended infusion (over 4 hours) of doripenem on clinical outcomes in critically ill patients. 

Methods: We performed cohort study of Intensive Care Unit (ICU) patients that received extended infusion of doripenem during the period of January-April 2011.  Extended infusion of doripenem was implemented at our hospital in October 2010.  Prior to that day, all patients received intermittent infusion of doripenem.  Baseline characteristics, length of ICU and hospital stay, and mortality rate were assessed via the University Health Consortium.

Results: A total of 65 patients were included in two study groups: 35 patients in the pre-implementation group and 30 patients in the post-implementation group.  Mortality trended downwards from 34% in 2010 to 23% in 2011. The mortality index decreased from 1.22 in 2010 to 0.93 in 2011. Length of stay was 25.17 days in 2010 compared to 24.87 in 2011. The length of stay index trended downward from 1.51 in 2010 to 1.28 in 2011. 30-day readmission rates were 17.39% in 2010 versus 5.77% in 2011.

Conclusion: In a time of increasing antimicrobial resistance, extended infusion antibiotics provide an effective option to improve patient outcomes. Extending the infusion of doripenem showed a trending decrease in mortality rates and 30-day readmission rates.


Subject Category: A. Antimicrobial agents and Resistance

Mena Abaskharoun, PharmD, MBA1, John Salaki, MD, FACP2 and Stacy Hardeo, PharmD, BCPS1, (1)Pharmacy, Morristown Medical Center, Morristown, NJ, (2)Infectious Disease, Morristown Medical Center, Morristown, NJ

Disclosures:

M. Abaskharoun, None

J. Salaki, None

S. Hardeo, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.