500 mg as bolus followed by an extended infusion of 1500 mg of meropenem every 8 h failed to achieve in one-third of the patients an optimal PK/PD against non-resistant strains of these organisms: is CRRT responsible for this situation?

Comparison between meropenem and ceftolozane/tazobactam: possible influence of CRRT

“…A bolus of 500 mg followed by EI of 1500 mg every 8 h was predicted to achieve this target in all patients [ 3 ]. If drug dose adaptation was not adhered to in CRRT patients and continuous infusion (CI) not used in cases of pathogens with a MIC ≥ 4, as recommended [ 4 ] some patients may have been underdosed, even with 1 g every 8 h [ 3 , 4 ], as meropenem is significantly eliminated by CRRT [ 4 ]. In addition, in the same study adjunctive therapy with amikacin 15 mg/kg was permitted for the first 72 h of study treatment where ≥ 15% of Pseudomonas aeruginosa were known to be meropenem resistant [ 1 ].…”