Analysis of Influencing Risk Factors Influencing the First Monitoring of Substandard Steady-state Blood Trough Concentrations of Meropenem
10.3870/j.issn.1004-0781.2025.02.017
- VernacularTitle:美罗培南首次监测稳态血药谷浓度不达标的影响因素分析
- Author:
Haiyue BAI
1
;
Anni YU
;
Cuiyu YOU
;
Di ZHANG
Author Information
1. 西安交通大学第一附属医院药学部,西安 710061;西安高新医院药剂科,西安 710075
- Publication Type:Journal Article
- Keywords:
Meropenem;
Substandard concentration;
Brain injury;
Glomerular filtration rate;
Influence factors
- From:
Herald of Medicine
2025;44(2):281-286
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of substandard steady state blood trough concentration of meropenem in the first monitoring.Methods Patients who were treated with meropenem and monitored steady-state blood trough concentration from July 2021 to June 2023 in the First Affiliated Hospital of Xi'an Jiaotong University were selected as the study subjects,and the patient's age,gender,and other medical history data were recorded.The steady-state blood trough concentration of meropenem was determined and the target was identified.According to the monitoring results,the patients were categorized into the standard group(2.0-16.0 mg·L-1)and non-standard group(＜2.0 mg·L-1 in the low concentration group and＞16.0 mg·L-1 in the high concentration group).Univariate and multivariate logistic regression analyses of relevant variables were performed for the low and high concentration groups,respectively,compared with the standard group to screen for risk factors for substandard steady-state trough concentration of meropenem.Results A total of 324 patients were included,there were 189 cases(58.33％)were reached the standard concentration,while 135 cases(41.67％)were failed to meet the standard(86 cases in low concentration group and 49 cases in high concentration group).The results of multivariate logistic regression analysis showed that glomerular filtration rate(P＜0.05),abumin(P＜0.05)and craniocerebral diseases(P＜0.05)were risk factors in the low concentration group compared with the standard group,the glomerular filtration rate of patients with brain injury was significantly higher than patients without brain injury;cystatin-C(P＜0.05)was a protective factor for the concentration of meropenem in both groups.The daily dose of meropenem(P＜0.05)and procalcitonin(P＜0.05)were risk factors for high meropenem blood concentrations in the high-concentration group compared with the standard group,whereas glomerular filtration rate(P＜0.05)was ta protective factor for the concentration of meropenem in the two groups.Conclusion Glomerular filtration rate,albumin and brain injury were risk factors for low steady-state blood trough concentrations of meropenem,whereas daily dose of meropenem and procalcitonin of meropenem were risk factors of high steady-state blood trough concentrations of meropenem.
