Document Detail


Pharmacokinetics of meropenem in patients with various degrees of renal function, including patients with end-stage renal disease.
MedLine Citation:
PMID:  8452352     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The pharmacokinetics of meropenem were studied after intravenous infusion in 13 patients grouped according to the impairment of their renal function. Creatinine clearance (CLCR) was greater than 50, 50 to 30, and less than 30 ml/min in groups I, II, and III, respectively. Two other groups, groups IV and V, each comprising four patients with end-stage renal disease (CLCR, < 5 ml/min), were also studied, the former on days off of hemodialysis and the latter on days of hemodialysis. The elimination half-lives of meropenem were 1.54 +/- 0.70 h in group I patients, 3.36 +/- 1.02 h in group II patients, and 5.00 +/- 1.05 h in group III patients. Cumulative urinary excretion accounted for 48.5% of the dose in group I patients and decreased progressively with a decline in renal function. Hemodialysis shortened the elimination half-life of meropenem from 7.0 h to 2.9 h. H-4295, the main metabolite of meropenem, had a peak level in plasma of 0.5 to 1.0 h in patients with renal failure. The level of H-4295 decreased with hemodialysis. The dosing interval of meropenem should be prolonged in a regular proportion to the decline in CLCR (12 h in group II patients and 24 h in group III patients). In patients receiving hemodialysis, dosing after each hemodialysis session is recommended.
Authors:
M Chimata; M Nagase; Y Suzuki; M Shimomura; S Kakuta
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Antimicrobial agents and chemotherapy     Volume:  37     ISSN:  0066-4804     ISO Abbreviation:  Antimicrob. Agents Chemother.     Publication Date:  1993 Feb 
Date Detail:
Created Date:  1993-04-15     Completed Date:  1993-04-15     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0315061     Medline TA:  Antimicrob Agents Chemother     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  229-33     Citation Subset:  IM    
Affiliation:
First Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chromatography, High Pressure Liquid
Creatinine / blood
Female
Humans
Infusions, Intravenous
Kidney Diseases / metabolism*
Kidney Failure, Chronic / metabolism*
Male
Middle Aged
Models, Biological
Pyrroles / blood*,  urine
Renal Dialysis
Thienamycins / blood,  pharmacokinetics*,  urine
Chemical
Reg. No./Substance:
0/Pyrroles; 0/Thienamycins; 124190-28-9/ICI 213689; 60-27-5/Creatinine; 96036-03-2/meropenem
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