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Optimal Meropenem Concentrations To Treat Multidrug-Resistant Pseudomonas aeruginosa Septic Shock

Optimal Meropenem Concentrations To Treat Multidrug-Resistant Pseudomonas aeruginosa Septic Shock Fabio Silvio Taccone a , Frédéric Cotton b , Sandrine Roisin c , Jean-Louis Vincent a and Frédérique Jacobs d a Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium b Department of Clinical Biology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium c Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium d Department of Infectious Diseases, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium ABSTRACT A patient with septic shock due to extensively drug resistant (XDR) Pseudomonas aeruginosa was cured by optimizing the meropenem (MEM) regimen to obtain at least 40% of the time between two administrations in which drug levels were four times higher than the MIC of the pathogen. As the standard drug dose did not achieve these optimal concentrations, the MEM regimen was progressively increased up to 12 g/day (3 g every 6 h in a 3-h extended infusion), which eventually resulted in sepsis resolution. High MEM dosage may represent a valuable therapeutic option for infection due to multidrug-resistant (MDR) strains, and drug monitoring would allow rapid regimen adjustment in clinical practice. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Antimicrobial Agents and Chemotherapy American Society For Microbiology

Optimal Meropenem Concentrations To Treat Multidrug-Resistant Pseudomonas aeruginosa Septic Shock

Abstract

Optimal Meropenem Concentrations To Treat Multidrug-Resistant Pseudomonas aeruginosa Septic Shock Fabio Silvio Taccone a , Frédéric Cotton b , Sandrine Roisin c , Jean-Louis Vincent a and Frédérique Jacobs d a Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium b Department of Clinical Biology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium c Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium d Department of Infectious Diseases, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium ABSTRACT A patient with septic shock due to extensively drug resistant (XDR) Pseudomonas aeruginosa was cured by optimizing the meropenem (MEM) regimen to obtain at least 40% of the time between two administrations in which drug levels were four times higher than the MIC of the pathogen. As the standard drug dose did not achieve these optimal concentrations, the MEM regimen was progressively increased up to 12 g/day (3 g every 6 h in a 3-h extended infusion), which eventually resulted in sepsis resolution. High MEM dosage may represent a valuable therapeutic option for infection due to multidrug-resistant (MDR) strains, and drug monitoring would allow rapid regimen adjustment in clinical practice.
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