Meropenem administered as a prolonged infusion to treat serious gram-negative central nervous system infections.
The treatment of gram-negative infection of the central nervous system (CNS) presents a clinical challenge due to antibiotic resistance and difficulties with penetration into the cerebrospinal fluid (CSF). Two patients with gram-negative CNS infections were treated successfully with high-dose, prolonged infusions of meropenem. The CSF meropenem concentrations exceeded the minimum inhibitory concentration of the pathogen for virtually the entire dosing interval in both cases. Our experience demonstrates that dosage modification to maximize pharmacodynamic targets and bactericidal activity may be practically applied to optimize antibiotic treatment for difficult-to-treat CNS infections.
Capitano
Blair
B
Antibiotic Management Program, Department of Pharmacy and Therapeutics, Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Nicolau
David P
DP
Potoski
Brian A
BA
Byers
Karin E
KE
Horowitz
Michael
M
Venkataramanan
Raman
R
Paterson
David L
DL
D000328:Adult; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy*; D000077731:Meropenem; D008875:Middle Aged; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D012706:Serratia marcescens / Q000187:drug effects; D013845:Thienamycins / Q000008:administration & dosage* / Q000097:blood / Q000494:pharmacology; D013997:Time Factors
D013845:Thienamycins; D000077731:Meropenem