The Practice of Prolonging Meropenem Infusion: A Narrative Review of Literatures Over the Last Decade: The Practice of Prolonging Meropenem Infusion: A Narrative Review of Literatures Over the Last Decade

Rifani Fauzi; Widyati Widyati; Ika Puspita Sari

doi:10.33084/jsm.v10i1.7162

Authors

Rifani Fauzi Universitas Gadjah Mada
Widyati Widyati Universitas Gadjah Mada
Ika Puspita Sari Universitas Gadjah Mada

DOI:

https://doi.org/10.33084/jsm.v10i1.7162

Keywords:

Meropenem, Prolonged infusion, Stability, Safety

Abstract

Background: The emergence of Antimicrobial Resistance (AMR) has forced clinicians and medical professionals to implement a strict Antimicrobial Stewardship policy. One of the pillar of Antimicrobial Stewardship is by optimizing the use of antibiotic agents. Beta-lactams demonstrate a time-dependent effect in combating bacteria. Since it is pharmacodynamically supported, a prolonged exposure via intravenous administration could be a feasible strategy to maximize the bactericidal effect. Meropenem, a beta-lactam antibiotic of carbapenems sub-class, also falls into the category above. However, there are questions to be answered regarding its stability, compatibility, safety, and clinical outcomes superiority compared to the standard intermittent infusion, before we can determine its effectiveness to be delivered as prolonged or extended infusion. Aims: This article would like to review literatures regarding the rationale behind the practice of prolonging meropenem infusion from the last decade. Method: For this narrative review we utilized articles extracted from Cochrane Library, ScienceDirect, and SageJournals databases from the last ten years. We also added complementary related articles from UpToDate®. Selected articles were limited to those published in english. Inclusion criteria specifically only including related articles to the practice of prolonging meropenem infusion on adult patients. A total of 18 articles were reviewed for the synthesis of this narrative review. Conclusion: Meropenem is eligible for prolonged infusion protocol since it is theoretically supported, adequate in stability, less concern for incompatibility, and potentially can provide better clinical outcomes compared to standard intermittent infusion.

Downloads

Download data is not yet available.

Author Biographies

References

Aboulatta, L., Sugita, H., Wakabayashi, H., Noma, H., & Sasaki, T. 2020. Comparison of extended versus intermittent infusion of antipseudomonal beta-lactams for the treatment of critically ill patients with respiratory infections: A systematic review and meta-analysis. International Journal of Infectious Diseases, 98, 41–50. https://doi.org/10.1016/j.ijid.2020.06.022

Ahmed, N., Jen, S.-P., Altshuler, D., Papadopoulos, J., Pham, V. P., & Dubrovskaya, Y. 2020. Evaluation of Meropenem Extended Versus Intermittent Infusion Dosing Protocol in Critically Ill Patients. Journal of Intensive Care Medicine, 35(8), 763–771. https://doi.org/10.1177/0885066618784264

Alsultan, A., Dasuqi, S. A., Aljamaan, F., Omran, R. A., Syed, S. A., AlJaloud, T., AlAhmadi, A., Alqahtani, S., & Hamad, M. A. 2021. Pharmacokinetics of meropenem in critically ill patients in Saudi Arabia. Saudi Pharmaceutical Journal, 29(11), 1272–1277. https://doi.org/10.1016/j.jsps.2021.09.017

Arnold, H. M., Hollands, J. M., Skrupky, L. P., Smith, J. R., Juang, P. H., Hampton, N. B., McCormick, S., Reichley, R. M., Hoban, A., Hoffmann, J., Micek, S. T., & Kollef, M. H. 2013. Prolonged Infusion Antibiotics for Suspected Gram-Negative Infections in the ICU: A Before-After Study. Annals of Pharmacotherapy, 47(2), 170–180. https://doi.org/10.1345/aph.1R523

Barlam, T. F., Cosgrove, S. E., Abbo, L. M., MacDougall, C., Schuetz, A. N., Septimus, E. J., Srinivasan, A., Dellit, T. H., Falck-Ytter, Y. T., Fishman, N. O., Hamilton, C. W., Jenkins, T. C., Lipsett, P. A., Malani, P. N., May, L. S., Moran, G. J., Neuhauser, M. M., Newland, J. G., Ohl, C. A., … Trivedi, K. K. 2016. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 62(10), e51-77. https://doi.org/10.1093/cid/ciw118

Bush, K., & Bradford, P. A. 2016. β-Lactams and β-Lactamase Inhibitors: An Overview. Cold Spring Harbor Perspectives in Medicine, 6(8),a025247.https://doi.org/10.1101/cshperspect.a025247

Chen, I. H., Martin, E. K., Nicolau, D. P., & Kuti, J. L. 2020. Assessment of Meropenem and Vaborbactam Room Temperature and Refrigerated Stability in Polyvinyl Chloride Bags and Elastomeric Devices. Clinical Therapeutics, 42(4), 606–613. https://doi.org/10.1016/j.clinthera.2020.01.021

Corcione, S., D’Avolio, A., Loia, R. C., Pensa, A., Segala, F. V., De Nicolò, A., Fatiguso, G., Romeo, M., Di Perri, G., Stella, M., & De Rosa, F. G. 2020. Pharmacokinetics of meropenem in burn patients with infections caused by Gram-negative bacteria: Are we getting close to the right treatment? Journal of Global Antimicrobial Resistance, 20, 22–27. https://doi.org/10.1016/j.jgar.2019.06.011

Craig, W.A. 1998. Pharmacokinetic/Pharmacodynamic Parameters: Rationale for Antibacterial Dosing of Mice and Men. Clinical Infectious Diseases, 26(1), 1–10.

Dhaese, S. A. M., De Kezel, M., Callant, M., Boelens, J., De Bus, L., Depuydt, P., & De Waele, J. J. 2018. Emergence of antimicrobial resistance to piperacillin/tazobactam or meropenem in the ICU: Intermittent versus continuous infusion. A retrospective cohort study. Journal of Critical Care, 47, 164–168. https://doi.org/10.1016/j.jcrc.2018.07.003

Eisert, A., Lanckohr, C., Frey, J., Frey, O., Wicha, S. G., Horn, D., Ellger, B., Schuerholz, T., Marx, G., & Simon, T.-P. 2021. Comparison of two empirical prolonged infusion dosing regimens for meropenem in patients with septic shock: A two-center pilot study. International Journal of Antimicrobial Agents, 57(3), 106289. https://doi.org/10.1016/j.ijantimicag.2021.106289

Fawaz, S., Barton, S., Whitney, L., Swinden, J., & Nabhani-Gebara, S. 2019. Stability of Meropenem After Reconstitution for Administration by Prolonged Infusion. Hospital Pharmacy, 54(3), 190–196. https://doi.org/10.1177/0018578718779009

Frippiat, F., Musuamba, F. T., Seidel, L., Albert, A., Denooz, R., Charlier, C., Van Bambeke, F., Wallemacq, P., Descy, J., Lambermont, B., Layios, N., Damas, P., & Moutschen, M. 2015. Modelled target attainment after meropenem infusion in patients with severe nosocomial pneumonia: The PROMESSE study. Journal of Antimicrobial Chemotherapy, 70(1), 207–216. https://doi.org/10.1093/jac/dku354

Gillespie, E. L., Kuti, J. L., & Nicolau, D. P. 2005. Pharmacodynamics of antimicrobials: Treatment optimisation. Expert Opinion on Drug Metabolism & Toxicology, 1(3), 351–361. https://doi.org/10.1517/17425255.1.3.351

Giménez-Giner, S., Llopis-Alemany, A., Porta-Oltra, B., Llopis-Salvia, P., Climente-Martí, M., & Martínez-Gómez, M. A. 2023. Chemical stability and physical compatibility of meropenem in admixtures for continuous and extended intravenous infusions. Enfermedades Infecciosas y Microbiologia Clinica (English Ed.), S2529993X23000230. https://doi.org/10.1016/j.eimce.2022.07.010

Kiratisin, P., Keel, R. A., & Nicolau, D. P. 2013. Pharmacodynamic profiling of doripenem, imipenem and meropenem against prevalent Gram-negative organisms in the Asia-Pacific region. International Journal of Antimicrobial Agents, 41(1), 47–51. https://doi.org/10.1016/j.ijantimicag.2012.09.007

Kollef, M. H., Chastre, J., Clavel, M., Restrepo, M. I., Michiels, B., Kaniga, K., Cirillo, I., Kimko, H., & Redman, R. 2012. A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia. Critical Care (London, England), 16(6), R218. https://doi.org/10.1186/cc11862

Kondo, Y., Ota, K., Imura, H., Hara, N., & Shime, N. 2020. Prolonged versus intermittent β-lactam antibiotics intravenous infusion strategy in sepsis or septic shock patients: A systematic review with meta-analysis and trial sequential analysis of randomized trials. Journal of Intensive Care, 8(1), 77. https://doi.org/10.1186/s40560-020-00490-z

Kong, L., Tang, Y., Zhang, X., Lu, G., Yu, M., Shi, Q., & Wu,X. 2017. Pharmacokinetic/ Pharmacodynamic Analysis of Meropenem for the Treatment of Nosocomial Pneumonia in Intracerebral Hemorrhage Patients by Monte Carlo Simulation. Annals of Pharmacotherapy, 51(11), 970–975. https://doi.org/10.1177/1060028017719715

Koomanachai, P., Yungyuen, T., Disthaporn, P., Kiratisin, P., & Nicolau, D. P. 2016. Application of Pharmacodynamic Profiling for the Selection of Optimal β-lactam Regimens in a Large University Hospital. International Journal of Infectious Diseases, 46,22–26. https://doi.org/10.1016/j.ijid.2016.03.020

Kuti, J. L. 2016. OPTIMIZING ANTIMICROBIAL PHARMACODYNAMICS: A GUIDE FOR YOUR STEWARDSHIP PROGRAM. Revista Médica Clínica Las Condes, 27(5), 615–624. https://doi.org/10.1016/j.rmclc.2016.08.001

Lan, J., Wu, Z., Wang, X., Wang, Y., Yao, F., Zhao, B., Wang, Y., Chen, J., & Chen, C. 2022. Population Pharmacokinetics Analysis and Dosing Simulations Of Meropenem in Critically Ill Patients with Pulmonary Infection. Journal of Pharmaceutical Sciences, 111(6),1833–1842. https://doi.org/10.1016/j.xphs.2022.01.015

Lessard, J.-J., Caron, E., Schérer, H., Forest, J.-M., & Leclair, G. 2020. Compatibility of Y-Site Injection of Meropenem Trihydrate With 101 Other Injectable Drugs. Hospital Pharmacy, 55(5), 332–337. https://doi.org/10.1177/0018578719844168

Lodise, T. P., Lomaestro, B. M., & Drusano, G. L. 2006. Application of Antimicrobial Pharmacodynamic Concepts into Clinical Practice: Focus on β-Lactam Antibiotics: Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy, 26(9),1320–1332. https://doi.org/10.1592/phco.26.9.1320

MacVane, S. H., Kuti, J. L., & Nicolau, D. P. 2014. Prolonging β-lactam infusion: A review of the rationale and evidence, and guidance for implementation. International Journal of Antimicrobial Agents, 43(2), 105–113. https://doi.org/10.1016/j.ijantimicag.2013.10.021

McEvoy, G. K., & American Society of Health System Pharmacists (Eds.). 2017. Handbook on injectable drugs: ASHP’s guide to IV compatibility and stability (19th edition). ASHP.

Merrem (Meropenem) IV Prescribing Information. 2013. AstraZeneca Pharmaceuticals LP.

Moehring, R., & Sarubbi, C. 2023. Prolonged infusions of beta-lactam antibiotics. https://www.uptodate.com/contents/prolonged-infusions-of-beta-lactam-antibiotics

Tomasello, C., Leggieri, A., Cavalli, R., Di Terri, G., & D’avolio, A. 2015. In Vitro Stability Evaluation of Different Pharmaceutical Products Containing Meropenem. Hospital Pharmacy, 50(4), 296–303. https://doi.org/10.1310/hpj5004-296

Venugopalan, V., Manigaba, K., Borgert, S. J., Cope, J., Peloquin, C. A., & Klinker, K. P. 2018. Training a Drug to Do New Tricks: Insights on Stability of Meropenem Administered as a Continuous Infusion. Microbiology Insights, 11,117863611880454. https://doi.org/10.1177/1178636118804549

World Health Organization. 2019. 2019 antibacterial agents in clinical development: An analysis of the antibacterial clinical development pipeline. World Health Organization. https://apps.who.int/iris/handle/10665/330420

The Practice of Prolonging Meropenem Infusion: A Narrative Review of Literatures Over the Last Decade