Optimal Usage of Meropenem Based on Recommended Regimen Derived from Monte Carlo Simulation

抄録

Long-term treatment with antibacterial agents is thought to be a cause of increased susceptibility to resistance.To prevent resistance in bacteria,a method of determining adequate regimens is needed and the Monte Carlo simulation (MCS) has proved useful for this purpose.In order to evaluate the inhibitory effect of the meropenem (MEPM) usage amount according to the recommended regimen based on the results of the MCS,we conducted a retrospective study using data from a database of inpatients at Iizuka hospital in 2006.We estimated the usefulness of the recommended regimen by comparing MEPM daily doses and the integrated frequency rate (IFR) of the percentage time it was above the MIC (%T>MIC) with those of the actual regimens.The results of doing this indicated that switching the actual regimens to MCS results-based regimens would have decreased the daily dose of MEPM by 43.9%.We also found that for the same dosing interval and daily dose,a regimen with a shorter infusion time achieved a higher IFR for %T>MIC values of 30% and 50%.This finding serves as a caution that just selecting a prolonged infusion time is not certain to raise the IFR of %T>MIC.Thus,the selection of appropriate dosages in consideration of the MIC of the pathogen and achieving high IFR levels will provide accurate and effective administration of MEPM