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| A clinical study on the dose selection of meropenem for sepsis patients with renal replacement treatment |
| Wang Yan-hong, Liu Yang |
| Department of Gerontology, Aerospace Central Hospital, Beijing 100049, China |
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Abstract Objective The sepsis patients are given different doses of meropenem during continuous renal replacement therapy (CRRT), therefore we aimed to investigate the curative effect and adverse reaction of different doses of meropenem.Methods From May 2014～May 2017, we retrospectively analyzed 72 patients with sepsis in our hospital. All the patients were given meropenem for anti-infection treatment and CRRT. All the patients were randomly divided into A group of 24 cases ［Meropenem (0.5 g/12 h) and 100 mL sodium (0.9%) chloride injection were diluted to give intravenous drip］; 24 cases in group B ［Meropenem (1g/12h) and 100 mL sodium (0.9%) chloride injection were diluted to give intravenous drip］; 24 cases in group C ［Meropenem (2g/12h) and 100 mL sodium (0.9%) chloride injection were diluted to give intravenous drip］; plasma concentration before and after treatment, the APACHE Ⅱ score and serum procalcitonin (PCT) changes after treatment, identification of the bacterial strains, bacterial clearance after treatment and adverse reaction after medication were respectively detected or recorded.Results %T>MIC in group A was 51.43±2.87, in group B was 80.13±7.14, in group C was 86.57±4.66, %T>MIC in group C was the highest, the difference among the groups was significant (F=311.37,P<0.01). PCT in group A, B and C were(1.68±1.22) ng/L,(1.54±1.27) ng/L and (1.31±1.08) ng/L, respectively, and there were no significant differences among the groups(F=0.589,P=0.558). APACHE Ⅱ score in group A, B and C were (13.72±4.55),(13.11±4.35) and (11.01±4.62), respectively; there was no significant difference between the groups (F=2.387,P=0.099). In group A, G-bacteria were detected in 8 cases (33.33%), group B was detected in 6 cases (25.00%), and group C was detected in 4 cases (16.67%). Bacterial clearance rates of group A, B and C were 62.50%, 70.83% and 87.50%, respectively; there was statistical significant differences among the groups (P<0.05).Conclusion Meropenem dose increase can increase the value of %T>MIC, CRRT in patients with sepsis in the use of meropenem can effectively remove bacteria. The present study provides clinical reference for meropenem using in sepsis patients that high dose shows better bacteria scavenging effect than low dose.
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| About author:: Wang Yan-hong, E-mail: xqx071107@163.com |
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