2012 Volume 3 Issue 2 Pages 123-128
Pharmacokinetics of meropenem (MEPM) in patients undergoing continuous hemodiafiltrarion (CHDF) has not been fully elucidated in Japan. Therefore, we evaluated the pharmacokinetics of MEPM to obtain optimal dose and times of MEPM infusion under CHDF therapy. Eight patients with multiple organ failure and anuria due to sepsis who needed CHDF treatment were injected 0.5 gram of MEPM twice daily. Among 8 patients, 4 patients used polysulfone (PS) membrane and 4 patients used polymethyl methacrylate (PMMA) membrane, and blood concentrations of MEPM were sequentially evaluated. Time above MIC (%T＞MIC) of MEPM more than 40～50% is usually thought to be effective and sufficient to sterilize bacteria. In our study, drip infusion of MEPM 0.5 gram twice daily under CHDF(blood flow 100mL/minute, dialysate flow 300mL/hour, replacement flow 300 mL/hour)could achieve effective therapeutic dose (%T＞MIC more than 50%) if the MIC of bacteria against MEPM was below 4µg/mL. Blood concentration of MEPM did not differ between PS and PMMA group. In critically ill patients with severe infection, adequate administration of antibiotics is crucial. Therefore, evidence of antibiotic pharmacokinetics under CHDF therapy should be accumulated to obtain optimal effect for such patients.
