Vol.61 No.5 September 2013

Accumulation of cases of high dose meropenem in our hospital

Masaki Nakamura^1,2), Yoko Takayama²⁾, Rumiko Kondo³⁾, Nobuhiko Nakazaki⁴⁾, Shin Nihonyanagi⁴⁾, Chie Sato⁵⁾, Yuko Tsunoda⁶⁾, Kuniko Fujiki²⁾, Yumiko Takagi²⁾, Yasuyoshi Hirata²⁾, Hideaki Hanaki⁷⁾ and Keisuke Sunakawa^2,8)

¹⁾Department of Laboratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, Japan
²⁾Department of Infection Control & Prevention, Kitasato University Hospital
³⁾Department of Pharmacy, Kitasato University Hospital
⁴⁾Department of Medical Laboratory, Kitasato University Hospital
⁵⁾Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
⁶⁾Department of Transfusion and Cell Transplantation Medicine, Kitasato University School of Medicine
(Present: Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University)
⁷⁾Kitasato Research Center for Anti-infection Drugs
⁸⁾Kitasato University Research Organization for Infection Control Sciences

Abstract

Meropenem(MEPM) is used widely for severe or refractory infectious deseases. The approved daily dose of MEPM is up to 3 g in Japan, despite approval for 6 g in Europe and the United States. For severe infectious deseases such as meningitis, in Japan it is also believed necessary to administer MEPM 6 g daily. So we retrospectively investigated the cases who received MEPM 6 g daily for bacterial meningitis in our hospital, and examined the patient background, effectiveness, and safety of high dose MEPM therapy.
Our final study subjects comprised 9 cases, and the treatment period was 21.4 days on the average. In all cases, the isolated pathogens from cerebrospinal fluid were eliminated within 14 days by administration of high dose MEPM. Liver dysfunctions (mild to moderate) were observed in some cases, but severe adverse effects such as convulsion were not observed.
The number of cases with high dose MEPM therapy for bacterial meningitis is increasing in Japan. However, the evidence for the efficacy and safety of high dose MEPM therapy remains insufficient. It is thought that further studies for the efficacy and safety of high dose MEPM therapy are needed.

Key word

meropenem, high dose therapy, safety, effectiveness

Received

August 23, 2012

Accepted

July 8, 2013

Jpn. J. Chemother. 61 (5): 435-438, 2013