Population pharmacokinetics of meropenem in febrile neutropenic patients in Korea
Yim, Dong-Seok (1), Dong-Gun Lee, Su-Mi Choi, Wan-Shik Shin, Hyon-oh Lah(1)
Departments of Internal Medicine and (1)Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Objectives: To explore the PK-PD relationship of meropenem in febrile neutropenic patients in
Methods: Fifty seven febrile neutropenic patients treated with meropenem 0.5 g q 8 h were enrolled into a population PK study. Venous blood was withdrawn 2-3 h (for peak) and 5-6 h (for trough) after the injection at steady state. Population PK parameters of meropenem were estimated using NONMEM (Ver. 5.1.1.). The MIC data for clinically isolated Pseudomonas aeruginosa and Escherichia coli and the population PK parameters obtained therein were applied to simulate the time above MIC (TAM) using the Monte-Carlo method.
Results: In 1,000 simulated patients treated with meropenem 0.5 g or 1 g q 8h, the proportions of patients who had a TAM lower than 40% of the dosing interval were 46.3% (0.5 g) and 35.6% (1 g) for P. aeruginosa and 5.9% (0.5 g) and 5.4% (1 g) for E. coli, respectively.
Conclusion: The overwhelming resistance of the pathogenic microorganisms, especially P. aeruginosa in our data compared to those reported in