title: Meropenem administered as a prolonged infusion to treat serious gram-negative central nervous system infections.
abstract: 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.
authors.affiliation: Antibiotic Management Program, Department of Pharmacy and Therapeutics, Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Blair
authors.initials: B
authors.lastname: Capitano
authors.forename: David P
authors.initials: DP
authors.lastname: Nicolau
authors.forename: Brian A
authors.initials: BA
authors.lastname: Potoski
authors.forename: Karin E
authors.initials: KE
authors.lastname: Byers
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
authors.forename: Raman
authors.initials: R
authors.lastname: Venkataramanan
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
mesh_terms: 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
chemical_list: D013845:Thienamycins; D000077731:Meropenem