If the YCD 95% minimum content limit is applied, the infusion period must be reduced to less than 6 hours for body-worn devices, especially at the higher concentration studied (25 mg/mL). Solution #2: Meropenem 100mg/50mL 0.9%NaCl for a concentration of 2mg/mL. Traditionally, meropenem has been dosed 1 g IV q 8 hrs for serious infections. Preparation of Solution: 3 g/day continuous IV infusion: Reconstitute a 1 g vial according to manufacturer recommendations. 63 Therefore, continuous infusion of meropenem 3 g/day could be divided into six … Doses of 1 gram may also be a… Objective To evaluate current … hÞbbd``b`Ö õ@‚Q Ä5±Ê€ÄwLŒÌ­ YF$âÿ¿ ñì Place in a 100mL bag of 0.9%NaCl to create a Meropenem concentration of 4mg/100mL (0.04mg/mL). Doses of 1 gram may also be administered as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes . Continuous IV Infusion: NOTE: Meropenem has not been FDA-approved for administration as a continuous intravenous infusion. The results suggest that cefiderocol is a potential option for the treatment of patients with nosocomial pneumonia, including those caused by multidrug-resistant Gram-negative bacteria. Adjust meropenem 1g IV q8hr to 500mg IV q6hr 2. We aimed to determine whether a 3-h extended infusion (EI) of meropenem achieves fT > MIC > 40 on the first and third days of therapy in patients with … Hence, administering these antibiotics by continuous infusion should improve the outcomes of … In the EI group, 18/76 patients (23.7%) received some of the meropenem doses for less than the 4–hour infusion time due to technical reasons; the mean infusion time per dose during the first 2 days of treatment was 3.62 hours (standard deviation, 0.41 hours) in the EI group. Renal Dosing Adjustment for Pediatric Patients all ages <40kg: • CrCl > 40ml/min = no adjustment Optimal anti-bacterial activity of meropenem requires maintenance of its plasma concentration (Cp) above the minimum inhibitory concentration (MIC) of the pathogen for at least 40% of the dosing interval (fT > MIC > 40). For intravenous infusion, meropenem vials may be directly reconstituted with 0.9 % sodium chloride or 5% glucose solutions for infusion. Meropenem (Meronem ®, AstraZeneca Pharmaceuticals, Belgium) was administered as either II (infusion over 0.5 h) in 30 patients (II group) or EI (infusion over 3 h) in 25 patients (EI group), at a dose of 1 g every 8 h, which is usually recommended in nosocomial pneumonia. The medicine must be injected slowly, so the needle will need to stay in place for at least 15 to 30 minutes. One gram of meropenem was administered by intravenous infusion for 30 min. endobj %PDF-1.5 %âãÏÓ Cefiderocol was non-inferior to high-dose, extended-infusion meropenem in terms of all-cause mortality on day 14 in patients with Gram-negative nosocomial pneumonia, with similar tolerability. Why: • PD target for β-lactams: fT>MIC (time above MIC) • Maximize the time-dependent bactericidal activity • Target pathogens with high MIC (e.g. endobj Proper use of meropenem A nurse or other trained health professional will give you or your child meropenem. For other pediatric patients less than 1 year of age the pharmacist must discuss the dose adjustment with the medical team who initiated the order. stream Meropenem’s stability was examined at two temperatures 22°C and 33°C to mimic average and high temperature in hospital wards. The protocol consists of a model previously performed in other tissues . For intravenous infusion, meropenem vials may be directly constituted with 0.9 % sodium chloride or 5% glucose solutions for infusion. %PDF-1.5 Methods: An open-label randomized controlled clinical trial was conducted. * Extended infusion not applicable to NICU patients. hÞb```¢ ÉÆ Ā BÌ,@ȱ˜A€ƒA„9x‚à„e‘Œ¼˜X3È7d3Ë0\`è?´hómnÎ@± F†X» Üg˜Ä:ÂÌÝv;¿ìöÛm„[[%[‚%\ ¬á Blood samples were drawn from a peripheral vein at the end of the infusion (T1), one hour later (T2), and two hours later (T3). 1 0 obj Interview By: Timothy P. Gauthier, Pharm.D., BCPS-AQ ID [Last … In this retrospective study, we compared intensive care unit (ICU) mortality and clinical response in patients who received meropenem for ≥72 hours administered per EIM protocol of 1 g over 3 hours every 8 hours versus intermittent infusion (IIM) protocol of 500 mg over 30 minutes every 6 hours. For example, a prolonged infusion of high-dose meropenem (2 g q8h, with each dose infused over 3 h) achieves a high likelihood of obtaining a 40% ƒT>MIC against bacteria with MICs of ≤16 μg/ml. The solution should be shaken before use . Study Protocol. 0 Extended-Infusion Meropenem (Merrem®) Protocol Related Documents: Patient Care Manual Guide: Medication Administration IV Infusion Guidelines I. Meropenem for injection (I.V.) •In order to optimize the pharmacodynamics of meropenem, cefepime, and piperacillin/tazobactam, dosing substitution protocols have been approved for inpatients at The Nebraska Medical Center. The protocol consists of a model previously performed in other tissues . 1014 0 obj <> endobj <> It is given through a needle placed into one of your veins. Several studies have explored the PK/PD parameters of beta lactam agents with Conclusions Meropenem at concentrations between 6.25 mg/mL and 25 mg/mL as tested is not sufficiently stable to administer as a 24-hour infusion in ambulatory device reservoirs. However, application of the PK/PD properties of meropenem to create alternative dosing strategies results in equivalent or even greater clinical success. Microbiologic success is dependent on pharmacokinetic and pharmacodynamic parameters and the organism’s MIC.8 As previously mentioned, the pharmacodynamic target for beta-lactam antibiotics is the time the drug concentration remains above the MIC of the infecting organism. Meropenem was subsequently assayed using high-performance liquid chromatography (HPLC). e Ÿ£ƒBÿ CȑõË5 ÍĜ  cTbàrC˜0ˆÆ>q0¿tŽ= ˜nl'AZ¸Œ@ZX€T;÷O0—á'@€ Þ``c Meropenem: Same dose: consider prolonged infusion for critically ill patients Prolonged infusion if critically ill, obese with Cl cr > 100 ml/min, if targeting a higher PD end point of 100% fT > MIC, or infections with less susceptible pathogens (i.e., MIC > 2) Monobactam: Aztreonam: Insufficient data Theoretically, therefore, this meropenem regimen should kill KPC-producing bacteria with MICs of 16 μg/ml or less. b. Meropenem to be used for bolus intravenous injection should be reconstituted with sterile water for injection. Remove 2mL from Solution #2. hÞÔSÛnÛ0ýý@GJ¾)@a ɚm@7M±ò 9‚#À•[)²¿)9Ù²§½ÖmŠ"uŽäC‰J endstream endobj startxref One gram of meropenem was administered by intravenous infusion for 30 min. protocol does NOT include patients in the neonatal intensive care unit. (UW Health Weak/Conditional Recommendation, <> Then adjust 500mg IV q6h for renal function = 500mg IV q8hr. is 500 mg given every 8 hours for skin and skin structure infections and 1 gram given every 8 hours for intra-abdominal infections. 62 The 40 mg/mL solution of meropenem reconstituted in isotonic saline was stable at 25°C for a maximum of 8 hours. Blood samples were drawn from a peripheral vein at the end of the infusion (T1), one hour later (T2), and two hours later (T3). The 5 mg/mL aqueous reconstituted solution of meropenem was stable for up to 8 hours in the temperature range between 25°C and 35°C, and for up to 5 hours at 40°C. Infusion. (UW Health Strong Recommendation, Low Quality of Evidence) 4. * IV push available, however, prolonged infusion is the preferred method of administration ** 30-60 minute infusion on Freedom 60 pump, no IV push available *** 60-90 minute infusion on Freedom 60 pump, no IV push available Factors that prohibit short infusions or IV push antibiotics with OPAT may include (but are not limited to): endstream endobj 1015 0 obj <>/Metadata 80 0 R/Pages 1012 0 R/StructTreeRoot 110 0 R/Type/Catalog>> endobj 1016 0 obj <>/MediaBox[0 0 720 540]/Parent 1012 0 R/Resources<>/Pattern<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1017 0 obj <>stream Tazocin® and Meropenem are beta-lactam antibiotics, whose efficacy is dependent upon time above minimum inhibitory concentration (MIC) in affected tissues. Further dilute in 50 mL or 250 mL of 0.9% Sodium Chloride Injection and administer over 8 hours. pseudomonas) How: 1. 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2020 meropenem infusion protocol