Population pharmacokinetics of meropenem:A review in adult patients with sepsis or septic shock
Objective This study developed a population pharmacokinetic(PopPK)model of meropenem in adult patients with sepsis or septic shock.It identified the factors that influence changes in the drug's pharmacokinetics in these individuals.The aim was to explore a new target for meropenem in PopPK studies including this patient group.Methods PopPK studies of meropenem in patients with sepsis or septic shock published from January 2012 to March 2023 were found in the PubMed and Medline databases,and relevant references were screened.Results In total,12 studies were deemed eligible for this review,and the one-and two-compartment models were reported to best describe the PopPK of meropenem in three and eight studies,respectively.More than 40 covariates were screened;the most common covariates were creatinine clearance and body weight,with age acting as a secondary factor.The estimated values of the clearance rate and total apparent distribution volume of meropenem varied greatly in the range of 1.5～14.1 L/h and 11.3～39.7 L,respectively.More than 50％of the studies applied the exponential model.Conclusion This review emphasized the extensiveness and variability of PopPK parameters estimated for this population and provided covariates that affected clearance and the apparent volume of distribution in this patient group.Second,prolonged infusion time and therapeutic drug monitoring seemed more suited for maintaining effective inhibitory concentrations,as widely reported,although further studies were warranted to draw reliable conclusions.The cumulative information obtained from this review could guide the drug administration system in this population.
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