Penetration of meropenem into heart valve tissue.

Thirty-three patients requiring cardiac valve surgery were administered meropenem 1000 mg by a 5 to 10 min iv injection. Samples of blood, cardiac valve and atrial muscle tissue were removed at valvectomy and analysed for meropenem by high performance liquid chromatography (HPLC) with UV detection. The plasma concentrations observed in the samples from these patients were higher than those reported when meropenem 1000 mg was administered to healthy volunteers by 5 min iv injection. No clinical adverse events attributable to meropenem were reported and the single 1000 mg dose was well tolerated. The penetration of meropenem into cardiac muscle and valve tissue was rapid and in excess of that expected solely on the basis of distribution into extracellular fluid. The concentrations achieved in the tissues were in excess of the MICs of the pathogens commonly causing endocarditis.