A population pharmacokinetic model that satisfactorily described the disposition and variability of meropenem in our Japanese population is described. NONMEM analysis showed that the clearance of meropenem depended on modified serum creatinine. The results of this study should help Japanese patients on meropenem by improving the prediction accuracy of dosing using the Bayesian method.

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Background: There are a few infectious disease (ID) specialists in Japan. A solution to promote the implementation of antimicrobial stewardship activities under these resource-limited settings is required.Methods: We compared carbapenem consumption between a 24-month baseline and 12-month intervention periods. During the intervention period, an ID specialist provided daily advises through a chart review and ID consultation service to prescribers against all prolonged carbapenem use (≥ 14 days). Additionally, we send an aggregated table containing the weekly point prevalence amount of each departmental carbapenem use for 7–13 and ≥ 14 days through e-mail to all doctors.Results: Among the 1,241 carbapenem courses during the intervention period, the ID specialist provided a total of 96 instances of feedback regarding carbapenem use for ≥ 14 days, and the feedback acceptance rate was 76%. After the initiation of the intervention, the trend in monthly carbapenem consumption changed (coefficient: -0.62; 95% CI: -1.15 to -0.087, p = 0.024), and its consumption decreased (coefficient: -0.098; 95% CI: -0.16 to -0.039, p = 0.002) without an increase in the consumption of broad-spectrum antimicrobials or in-hospital mortality. Interestingly, the monthly number of carbapenem courses, but not the duration of carbapenem use, significantly decreased (coefficient: -3.02; 95% CI: -4.63 to -1.42, p = 0.001). The carbapenem-related annual estimated savings after the intervention was $83,745, with a 22% cost reduction.Conclusions: Our ID specialist-led daily intervention with weekly feedback regarding long-term carbapenem use was effective in reducing antimicrobial consumption. Such feedback may be useful in changing the prescribing behavior and promoting appropriate antimicrobial usage even in resource-limited settings.