Pharmacokinetics of high-dose extended-infusion meropenem during pulmonary exacerbation in adult cystic fibrosis patients: A case series

Emanuele Delfino, Carmen Fucile, Valerio Del Bono, Anna Marchese, Valeria Marini, Erika Coppo, Rosaria Casciaro, Laura Minicucci, Daniele Roberto Giacobbe, Antonietta Martelli, Claudio Viscoli, Francesca Mattioli

Research output: Contribution to journalArticle

Abstract

This case series explored the pharmacokinetic/pharmacodynamic (PK/PD) characteristics of meropenem (MEM) in adult cystic fibrosis (CF) patients hospitalized for a pulmonary exacerbation. From January 2015 to June 2016, all adult patients with cystic fibrosis (CF) and chronic pulmonary infection due to meropenem (MEM)-susceptible/intermediate Pseudomonas aeruginosa who received at least 48 h of MEM as an extended 3-hour infusion for treating a pulmonary exacerbation were enrolled. MEM plasma concentrations were determined by high-performance liquid chromatography. Six adult CF patients with a median age of 47 years were included in the study. MEM showed a high Vd (mean 45.98 L, standard deviation [SD]±34.45). A minimal PK/PD target of 40% T > minimum inhibitory concentration (MIC) with respect to the MEM MIC of P. aeruginosa strains isolated from sputum during exacerbation was achieved in 5/6 patients (83%). MEM failed to achieve this target only in one patient, whose strain showed the highest MEM MIC in our cohort (8 mg/L). In all patients, MEM was well tolerated, and no adverse events were reported. In conclusion, high-dose, extended-infusion MEM during pulmonary exacerbation showed a high Vd in six adult CF patients with high median age, and was well tolerated.

Original languageEnglish
Pages (from-to)47-51
Number of pages5
JournalNew Microbiologica
Volume41
Issue number1
Publication statusPublished - Jan 1 2018

Keywords

  • Cystic fibrosis
  • Meropenem
  • Pharmacokinetic
  • Therapeutic drug monitoring

ASJC Scopus subject areas

  • Microbiology (medical)

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    Delfino, E., Fucile, C., Del Bono, V., Marchese, A., Marini, V., Coppo, E., Casciaro, R., Minicucci, L., Giacobbe, D. R., Martelli, A., Viscoli, C., & Mattioli, F. (2018). Pharmacokinetics of high-dose extended-infusion meropenem during pulmonary exacerbation in adult cystic fibrosis patients: A case series. New Microbiologica, 41(1), 47-51.