title: A Review of Clinical Outcomes Associated with Two Meropenem Dosing Strategies.
abstract: Meropenem is a carbapenem antibiotic that exhibits time-dependent bactericidal activity, traditionally dosed intravenously at 1 g every 8 h. In order to maximize its pharmacodynamic activity and reduce costs, an alternative regimen employed by many institutions is 500 mg every 6 h. The objective of this review was to summarize and evaluate published literature comparing clinical outcomes associated with these two meropenem dosing regimens. The literature was searched up to October 2016 using the MEDLINE, EMBASE, and Google Scholar databases. Three retrospective cohort studies were identified that compared clinical outcomes in general infectious disease patients (two studies) and patients with febrile neutropenia (one study). All studies reported no difference in clinical outcomes (clinical success, time to defervescence, sign or symptom resolution, length of stay, mortality, need for other antibiotics, and seizure rates). One study reported reduced economic costs with the alternative dosing. Interpretation of findings was primarily limited by small sample sizes and generalizability. Based on the data reviewed, the alternative dosing regimen of meropenem 500 mg intravenously every 6 h could be considered a therapeutic option. Future studies are needed to confirm the findings of this review, especially in high-risk populations such as immunocompromised patients or those with severe infections.
authors.affiliation: College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar. kjw@qu.edu.qa.
authors.forename: Kyle John
authors.initials: KJ
authors.lastname: Wilby
authors.affiliation: College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar.
authors.forename: Ziad Ghantous
authors.initials: ZG
authors.lastname: Nasr
authors.affiliation: Pharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
authors.forename: Shereen
authors.initials: S
authors.lastname: Elazzazy
authors.affiliation: Pharmaceutical Sciences, Vancouver General Hospital, 899 W 12th Ave, Vancouver, BC, V5Z 1M9, Canada.
authors.forename: Tim T Y
authors.initials: TT
authors.lastname: Lau
authors.affiliation: Pharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
authors.forename: Anas
authors.initials: A
authors.lastname: Hamad
mesh_terms: D003141:Communicable Diseases / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D064147:Febrile Neutropenia / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D000077731:Meropenem; D013845:Thienamycins / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013845:Thienamycins; D000077731:Meropenem