Presented, in part, at the 2011 Annual Meeting of the American College of Clinical Pharmacy, October 16–19, 2011, Pittsburgh, Pennsylvania.
Steady-state pharmacokinetics and pharmacodynamics of meropenem in morbidly obese patients hospitalized in an intensive care unit
Article first published online: 19 OCT 2013
© 2013, The American College of Clinical Pharmacology
The Journal of Clinical Pharmacology
Volume 54, Issue 3, pages 324–330, March 2014
How to Cite
Cheatham, S. C., Fleming, M. R., Healy, D. P., Chung, E. K., Shea, K. M., Humphrey, M. L. and Kays, M. B. (2014), Steady-state pharmacokinetics and pharmacodynamics of meropenem in morbidly obese patients hospitalized in an intensive care unit. Journal of Clinical Pharma, 54: 324–330. doi: 10.1002/jcph.196
None of the authors are Fellows of the American College of Clinical Pharmacology.
- Issue published online: 11 FEB 2014
- Article first published online: 19 OCT 2013
- Accepted manuscript online: 5 OCT 2013 06:49AM EST
- Manuscript Accepted: 22 AUG 2013
- Manuscript Received: 1 AUG 2013
The study objective was to evaluate meropenem pharmacokinetics and pharmacodynamics in morbid obesity. Nine patients hospitalized in an intensive care unit with a body mass index ≥40 kg/m2 received meropenem 500 mg or 1 g q6h, infused over 0.5 hours. Pharmacokinetic parameters were estimated, and Monte Carlo simulations were performed for 5 dosing regimens (500 mg q8h, 1 g q8h, 2 g q8h, 500 mg q6h, 1 g q6h) infused over 0.5 and 3 hours. Probability of target attainment (PTA) was calculated using fT > MIC of 40% and 54%. Total body weight and body mass index were 152.3 ± 31.0 kg and 54.7 ± 8.6 kg/m2, respectively. Volume of distribution of the central compartment was 13.3 ± 6.7 L, volume of distribution at steady-state was 37.4 ± 14.7 L, and systemic clearance was 10.2 ± 5.0 L/h. At an MIC of 2 µg/mL, PTA was ≥90% for 4/5 and 2/5 regimens infused over 0.5 hours and for 5/5 and 4/5 regimens infused over 3 hours at 40% and 54% fT > MIC, respectively. Standard doses achieve adequate exposures for susceptible bacteria at a pharmacodynamic target of 40% fT > MIC. Higher doses or prolonged infusion regimens are needed at the higher pharmacodynamic target.