The relationship between the daily dosage of the carbapenem meropenem (MEPM) and MEPM-resistant Pseudomonas aeruginosa.

Author(s): Harashima S, Kondo H, Nabeshima A, Shimoda M, Yamaji K, Horiuchi T, Shimono N, Ikematsu H

Affiliation(s): Department of Clinical Research, Hara-doi Hospital, Fukuoka, Japan. harasima@metab.kuhp.kyoto-u.ac.jp

Publication date & source: 2008-06, J Infect Chemother., 14(3):219-22. Epub 2008 Jun 24.

Publication type:

Pseudomonas aeruginosa is a pathogen which is known to be responsible for nosocomial infection. The appropriate use of antibiotics has become important for preventing the spread of drug-resistant P. aeruginosa. In Hara-doi Hospital, two carbapenem antibiotics, imipenem (IPM) and meropenem (MEPM), are used for patients aged 65 years or older at a daily dosage of 1.0 g and 0.5 g, respectively. Of P. aeruginosa samples isolated in 2003, the sensitivity to IPM was 54% and to MEPM it was 58%. In 2004, the sensitivity to IPM was 55%, i.e., not significantly different from 2003. In 2004, the daily dosage of MEPM was increased to 1.0 g/day, and the sensitivity to MEPM increased to 71%. Based on the Pharmacokinetics/Pharmacodynamics (PK/PD) theory, even though the patients were elderly, a sufficient dosage of antibiotics given over a shorter period of time was effective against MEPM-resistant P. aeruginosa in a hospital ward, and there were no side effects.