A 48-year-old man on ICU has severe intra-abdominal sepsis requiring prolonged antibiotic therapy with IV meropenem. The team wishes to optimise merop...

Question

A 48-year-old man on ICU has severe intra-abdominal sepsis requiring prolonged antibiotic therapy with IV meropenem. The team wishes to optimise meropenem efficacy using a pharmacokinetic/pharmacodynamic (PK/PD) approach. Meropenem exhibits time-dependent killing. What dosing strategy best exploits this PK/PD property?

Accepted Answer

Extended or continuous infusion - meropenem's bactericidal activity depends on the time the free drug concentration remains above the MIC (fT>MIC); extending the infusion time (e.g. 3-hour infusion instead of 30-minute bolus) or continuous infusion maximises fT>MIC

Answer

Give a large single daily dose (once-daily dosing)

Answer

Intermittent bolus dosing with high peak levels

Answer

Oral dosing to improve absorption

Answer

PK/PD optimisation has no clinical relevance

uk-fficm MCQ (SBA): Beta-Lactam PK/PD Optimisation