Use of meropenem 3 g once daily for outpatient treatment of infective exacerbations of bronchiectasis.
Meropenem administered as a single iv 3 g dose once every 24 h was used to treat nine ambulatory patients with infective exacerbations of bronchiectasis. Serum meropenem concentrations were measured before dosing and at 30 min after each 30 min infusion. Mean pre-dose concentrations were <0.1 mg/L and mean post-dose concentrations 93.9 +/- 29.5 mg/L (95% confidence interval (CI) 86. 2-101.6, n = 59). A pathogen was cultured from sputum in six patients and eradicated (<100 cfu/g sputum) in all but one by day 6 of therapy. Previous work on animals has shown that a bacteriostatic effect is seen with meropenem when t > MIC is greater than 20-30% of the dose interval. In these nine patients, this could be achieved and was associated with successful outcome for pathogens for which MICs are </= 0.5 mg/L. Therefore, once-a-day meropenem therapy may be a useful option for outpatient treatment for isolates for which MICs are </= 0.5 mg/L.
Darley
E S
ES
Bristol Centre for Antimicrobial Research and Evaluation, North Bristol NHS Trust and University of Bristol, Department of Medical Microbiology, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.
Bowker
K E
KE
Lovering
A M
AM
Harvey
J E
JE
Macgowan
A P
AP
D000368:Aged; D001987:Bronchiectasis / Q000150:complications* / Q000382:microbiology; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000382:microbiology; D006193:Haemophilus influenzae; D006207:Half-Life; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology; D013845:Thienamycins / Q000627:therapeutic use*
D013845:Thienamycins; D000077731:Meropenem