Objective To explore the clinical efficacies of different daily doses of meropenem in patients with hyperactive renal function.Methods A retrospective analysis was conducted on 144 patients treated with meropenem at Dongying Second People's Hospital from January 2021 to December 2022.Based on the creatinine clearance rate(CCr),the patients were divided into a hyperactive renal function group(63 cases)and a normal renal function group(81 cases).In the hyperactivity group,there were 37 males and 26 females,aged 37-69(53.55±4.47)years,with a body mass of 46-93(71.51±6.06)kg,with a disease course of 1-6(2.98±0.93)years.In the normal group,there were 48 males and 33 females,aged 41-73(53.50± 4.42)years,with a body weight of 49-89(71.56±6.01)kg,with a disease course of 1-5(2.97± 0.95)years.The renal function[Ccr,serum creatinine(Scr),and blood urea nitrogen(BUN)],inflammatory indicators[white blood cell count(WBC),neutrophil percentage(NEUT％),procalcitonin(PCT),and C-reactive protein(CRP)],medication status,and clinical efficacy of different daily doses of meropenem were compared between the two groups.Independent sample t test and x2 test were used.Results The Ccr level in the hyperactivity group was higher than that in the normal group[(126.14±11.63)ml/min vs.(116.25±10.51)ml/min],but the levels of Scr[(47.66± 4.25)μmol/L]and BUN[(3.10±0.33)mmol/L]were lower than those in the normal group[(58.62± 5.62)μmol/L and(4.22±0.49)mmol/L],with statistically significant differences(all P＜0.05).The levels of WBC[(15.55±1.23)×109/L],NEUT％[(77.85±5.69)％],PCT[(48.60±4.12)μg/L],and CRP[(16.17±3.55)mg/L]in the hyperactivity group were higher than those in the normal group[(9.44± 1.56)×109/L,(68.52±5.52)％,(48.60±4.12)μg/L,and(9.23±1.06)mg/L],with statistically significant differences(all P＜0.05).The drug use of the hyperactivity group was higher than that of the normal group at 0.5 g dose(administered every 6 h and every 8 h)and 2.0 g dose(administered every 8 h),but lower than that of the normal group at 1.0 g dose(administered every 8 h and every 12 h),with statistically significant differences(all P＜0.05).The clinical effective rates of the hyperactivity group at 1/2 day dose and 2/3 day dose were 0(0/15 and 0/17),which were lower than those of the normal group[88.89％(8/9)and 92.31％(24/26)],with statistically significant differences(both P＜0.05).The clinical effective rate of the hyperactivity group at 1 day dose[50.00％(10/20)]was higher than those at 1/2 day dose and 2/3 day dose,but still lower than that of the normal group[75.61％(31/41)],with statistically significant differences(all P＜0.05).The clinical effective rate of the hyperactivity group at double daily dose was 81.82％(9/11),without statistically significant difference compared with 100.00％(5/5)of the normal group(P＞0.05).Conclusions Different doses of meropenem affect the clinical efficacy in patients with hyperactive renal function.The dosage should be ≥ 2.0 g(daily dose),and can be increased to 3.0 g if necessary.
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