Hyun Dong-Gon, Seo Jarim, Lee Su Yeon, Ahn Jee Hwan, Hong Sang-Bum, Lim Chae-Man, Koh Younsuck, Huh Jin Won
Department of Pulmonary and Critical Care Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Department of Pharmacy, Asan Medical Centre, Seoul 05505, Republic of Korea.
Antibiotics (Basel). 2023 Oct 15;12(10):1542. doi: 10.3390/antibiotics12101542.
The efficacy of extended meropenem infusions in patients with nosocomial pneumonia is not well defined. Therefore, we compared the clinical outcomes of extended versus intermittent meropenem infusions in the treatment of nosocomial pneumonia. We performed a retrospective analysis of extended versus intermittent meropenem infusions in adult patients who had been treated for nosocomial pneumonia at a medical ICU between 1 May 2018 and 30 April 2020. The primary outcome was mortality at 14 days. Overall, 64 patients who underwent an extended infusion and 97 with an intermittent infusion were included in this study. At 14 days, 10 (15.6%) patients in the extended group and 22 (22.7%) in the intermittent group had died (adjusted hazard ratio (HR), 0.55; 95% confidence interval (CI): 0.23-1.31; = 0.174). In the subgroup analysis, significant differences in mortality at day 14 were observed in patients following empirical treatment with meropenem (adjusted HR, 0.17; 95% CI: 0.03-0.96; = 0.045) and in Gram-negative pathogens identified by blood or sputum cultures (adjusted HR, 0.01; 95% CI: 0.01-0.83; = 0.033). Extended infusion of meropenem compared with intermittent infusion as a treatment option for nosocomial pneumonia may have a potential advantage in specific populations.
美罗培南延长输注对医院获得性肺炎患者的疗效尚不明确。因此，我们比较了美罗培南延长输注与间歇输注治疗医院获得性肺炎的临床结局。我们对2018年5月1日至2020年4月30日期间在某医疗重症监护病房接受医院获得性肺炎治疗的成年患者中，美罗培南延长输注与间歇输注进行了回顾性分析。主要结局是14天的死亡率。总体而言，本研究纳入了64例接受延长输注的患者和97例接受间歇输注的患者。14天时，延长输注组有10例（15.6%）患者死亡，间歇输注组有22例（22.7%）患者死亡（校正风险比（HR）为0.55；95%置信区间（CI）：0.23 - 1.31；P = 0.174）。在亚组分析中，美罗培南经验性治疗后的患者（校正HR，0.17；95% CI：0.03 - 0.96；P = 0.045）以及血培养或痰培养鉴定出的革兰阴性病原体患者（校正HR，0.01；95% CI：0.01 - 0.83；P = 0.033）在14天死亡率方面存在显著差异。作为医院获得性肺炎的一种治疗选择，与间歇输注相比，美罗培南延长输注可能在特定人群中具有潜在优势。
