Abstract
A patient with septic shock due to extensively drug resistant (XDR) Pseudomonas aeruginosa was cured by optimizing the meropenem (MEM) regimen to obtain at least 40% of the time between two administrations in which drug levels were four times higher than the MIC of the pathogen. As the standard drug dose did not achieve these optimal concentrations, the MEM regimen was progressively increased up to 12 g/day (3 g every 6 h in a 3-h extended infusion), which eventually resulted in sepsis resolution. High MEM dosage may represent a valuable therapeutic option for infection due to multidrug-resistant (MDR) strains, and drug monitoring would allow rapid regimen adjustment in clinical practice.
MeSH terms
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Aged
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Anti-Bacterial Agents / administration & dosage*
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Anti-Bacterial Agents / blood
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Anti-Bacterial Agents / therapeutic use*
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C-Reactive Protein / metabolism
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Drug Resistance, Multiple, Bacterial*
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Humans
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Male
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Meropenem
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Microbial Sensitivity Tests
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Norepinephrine / therapeutic use
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Obesity / complications
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Obesity / metabolism
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Pseudomonas Infections / drug therapy*
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Pseudomonas Infections / microbiology
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Pseudomonas aeruginosa / drug effects
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Respiration, Artificial
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Shock, Septic / drug therapy*
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Shock, Septic / microbiology
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Thienamycins / administration & dosage*
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Thienamycins / blood
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Thienamycins / therapeutic use*
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Vasoconstrictor Agents / therapeutic use
Substances
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Anti-Bacterial Agents
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Thienamycins
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Vasoconstrictor Agents
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C-Reactive Protein
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Meropenem
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Norepinephrine