Analysis of Pharmacokinetics/Pharmacodynamics Compliance and Influencing Factors of Meropenem Concentration in Patients with Augmented Renal Clearance
10.3870/j.issn.1004-0781.2024.01.019
- VernacularTitle:肾功能亢进患者美罗培南药动学/药效学达标情况及谷浓度影响因素
- Author:
Shenjue CHEN
1
,
2
;
Xin LI
;
Minyi WU
;
Lihua LIU
;
Xin HE
;
Meiyun LI
Author Information
1. 长沙市第三医院药学部,长沙 410015
2. 长沙市抗菌药物临床应用研究所,长沙 410015
- Keywords:
Meropenem;
Augmented renal clearance;
Blood concentration;
Pharmacokinetics;
Pharmacodynamics
- From:
Herald of Medicine
2024;43(1):122-126
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the pharmacokinetics/pharmacodynamics(PK/PD)parameters and influencing factors in patients with augmented renal clearance(ARC)to provide the basis for the rational use of meropenem.Methods Using the method of retrospective study,the patients with increased renal clearance who used meropenem monitored the concentration from January 2018 to December 2021.The PK/PD parameters of meropenem were analyzed,and multiple linear retrospective analyses discussed the influencing factors of meropenem valley concentration.Results A total of 58 patients were included in the study,and the trough concentration was 1.35[0.23,1.86]μg·mL-1,taking 100%fT＞MIC as PK/PD target value,the compliance rate was 20.69%.The compliance rate of daily dose＜3 g·d-1 was 8.70%,and≥3 g·d-1 was 31.43%,the difference was statistically significant.With MIC of 0.5,1,2,4,and 8 μg·mL-1,PK/PD compliance rates were 62.07%,48.28%,20.69%,8.62%and 0.Respectively.Multiple linear retrospective analyses showed that dose was an independent factor affecting meropenem valley concentration.Conclusion The PK/PD compliance rate of meropenem in patients with augmented renal clearance is low,even if MIC≤0.5 μg·mL-1,the routine dose is difficult to achieve the ideal PK/PD,so the clinical should recognize ARC and perform TDM as soon as possible,and use TDM to guide the medication regimen of meropenem for ARC patients.
