Pharmacokinetics of meropenem for critically ill patients
Project/Area Number |
16K20377
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Research Category |
Grant-in-Aid for Young Scientists (B)
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Allocation Type | Multi-year Fund |
Research Field |
Emergency medicine
|
Research Institution | Chiba University |
Principal Investigator |
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Project Period (FY) |
2016-04-01 – 2020-03-31
|
Project Status |
Completed (Fiscal Year 2019)
|
Budget Amount *help |
¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000)
Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2016: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
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Keywords | 敗血症 / 重症感染症 / メロペネム / 血中濃度 / TDM / 抗菌薬適正使用 |
Outline of Final Research Achievements |
In this project, we evaluated the pharmacokinetic models of meropenem among critically ill patients. The best suitable model was 2-compartment model. Furthermore, we analyzed the pharmacokinetics of meropenem in critically ill patients with acute kidney injury treated with continuous hemodiafiltration. Our results indicated that a meropenem dosage of 0.5 g every 8 hours or 1 g every 12 hours was suitable in this population. The protocol enabled to achieve 100% time above the minimum inhibitory concentration for bacteria with a minimum inhibitory concentration less than 2 mg/L.
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Academic Significance and Societal Importance of the Research Achievements |
MEPMは敗血症に対し経験的に投与されることが多い広域抗菌薬であるが,重症患者では臓器不全や血液浄化療法の実施により血中濃度が不安定になりやすく,過少投与,過剰投与が懸念されていた.MEPM血中濃度を一般病院で測定することは困難であるが,本研究によりCHDF施行中の患者においても0.5g×8時間ごと,もしくは1g×12時間ごとの投与により十分な血中濃度が維持できることが確認されたため,今後TDMを施行する必要がないことが裏付けられた.同様に,治療効果が得られない場合には,MEPMを増量する意味はなく,MEPM耐性菌やMEPMが無効な病原体の関与を考え治療薬を変更すべきであることが明確となった.
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Report
(5 results)
Research Products
(6 results)