title: Optimal meropenem concentrations to treat multidrug-resistant Pseudomonas aeruginosa septic shock.
abstract: A patient with septic shock due to extensively drug resistant (XDR) Pseudomonas aeruginosa was cured by optimizing the meropenem (MEM) regimen to obtain at least 40% of the time between two administrations in which drug levels were four times higher than the MIC of the pathogen. As the standard drug dose did not achieve these optimal concentrations, the MEM regimen was progressively increased up to 12 g/day (3 g every 6 h in a 3-h extended infusion), which eventually resulted in sepsis resolution. High MEM dosage may represent a valuable therapeutic option for infection due to multidrug-resistant (MDR) strains, and drug monitoring would allow rapid regimen adjustment in clinical practice.
authors.affiliation: Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium. ftaccone@ulb.ac.be
authors.forename: Fabio Silvio
authors.initials: FS
authors.lastname: Taccone
authors.forename: Frédéric
authors.initials: F
authors.lastname: Cotton
authors.forename: Sandrine
authors.initials: S
authors.lastname: Roisin
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Frédérique
authors.initials: F
authors.lastname: Jacobs
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008297:Male; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D009638:Norepinephrine / Q000627:therapeutic use; D009765:Obesity / Q000150:complications / Q000378:metabolism; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D012121:Respiration, Artificial; D012772:Shock, Septic / Q000188:drug therapy* / Q000382:microbiology; D013845:Thienamycins / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014662:Vasoconstrictor Agents; D002097:C-Reactive Protein; D000077731:Meropenem; D009638:Norepinephrine