Safety of Megadose Meropenem in the Empirical Treatment of Nosocomial Sepsis: A Pilot Randomized Clinical Trial Publisher Pubmed



Salehi M¹ ; Rezazademoayed F¹ ; Khalili H² ; Hemati H² ; Aghdami N^{1, 3} ; Dashtkoohi M⁴ ; Dashtkoohi M⁴ ; Beigmohammadi MT⁵ ; Ramezani M⁵ ; Hajiabdolbaghi M¹ ; Fattahghazi S⁵
Source: Future Microbiology Published:2023

Abstract

Objective: To evaluate the safety of megadose meropenem as empirical treatment of nosocomial sepsis. Materials & methods: Critically ill patients diagnosed with sepsis received either high-dose (2 g every 8 h) or megadose (4 g every 8 h) meropenem as an intravenous infusion over 3 h. Results: A total of 23 patients with nosocomial sepsis were eligible and included in the megadose (n = 11) or high-dose (n = 12) group. No treatment-related adverse events were observed during a 14-day follow-up. Clinical response was also comparable between the groups. Conclusion: Megadose meropenem may be considered for empirical treatment of nosocomial sepsis without serious concern regarding its safety. Plain language summary As resistance to antibiotics is increasing among microbes, rational use of these drugs is important both in the community and in hospitals. Many infections with resistant microorganisms may be fatal. For a long time, carbapenems have been the last resort for treatment of resistant microorganisms. Unfortunately, resistance to these drugs is increasing. It appears that use of higher doses of antibiotics may help in some cases. However, the potential harm caused by higher doses is a problem. In this primary study, higher doses of meropenem, a common carbapenem, were found to be safe. © 2023 Future Medicine Ltd.