International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Continuous versus intermittent infusion of high-dose meropenem in critically ill patients: an observational cohort study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Bergmann Felix, Prager Marlene, Kumpf Katarina, Minichmayr Iris K, Gelbenegger Georg, Pracher Lena, Zeitlinger Markus, Jorda Anselm
Аннотация
BACKGROUND: Whether continuous infusion of high-dose meropenem improves outcomes compared with intermittent infusion in critically ill patients remains unclear.
METHODS: We conducted a retrospective propensity score-matched cohort study at a tertiary academic hospital in Vienna, Austria, including critically ill patients treated with high-dose meropenem between March 2014 and April 2024. Eligible patients had an ICU stay of ≥3 days and received meropenem 6 g/day (or 4 g/d in renal impairment) as continuous or intermittent infusion. Patients were matched 1:3 using propensity scores with covariate adjustment. The primary outcome was 90-day all-cause mortality. Secondary outcomes included 30-day mortality, emergence of carbapenem resistance, initiation of extracorporeal membrane oxygenation (ECMO), new-onset acute respiratory distress syndrome (ARDS), incidence of fever, and hospital length of stay.
RESULTS: Among 3768 patients receiving high-dose meropenem, 597 intermittent-infusion patients were matched with 199 continuous-infusion patients. Adjusted 90-day mortality was 39.5% (95% CI, 33.1-45.9) with continuous infusion and 35.9% (95% CI, 32.4-39.4) with intermittent infusion (adjusted risk difference, 3.7%; 95% CI, -3.7 to 11.0; p = 0.33). No significant differences were observed for secondary outcomes.
CONCLUSIONS: Continuous infusion of high-dose meropenem was not associated with improved outcomes compared with intermittent infusion in critically ill patients.
METHODS: We conducted a retrospective propensity score-matched cohort study at a tertiary academic hospital in Vienna, Austria, including critically ill patients treated with high-dose meropenem between March 2014 and April 2024. Eligible patients had an ICU stay of ≥3 days and received meropenem 6 g/day (or 4 g/d in renal impairment) as continuous or intermittent infusion. Patients were matched 1:3 using propensity scores with covariate adjustment. The primary outcome was 90-day all-cause mortality. Secondary outcomes included 30-day mortality, emergence of carbapenem resistance, initiation of extracorporeal membrane oxygenation (ECMO), new-onset acute respiratory distress syndrome (ARDS), incidence of fever, and hospital length of stay.
RESULTS: Among 3768 patients receiving high-dose meropenem, 597 intermittent-infusion patients were matched with 199 continuous-infusion patients. Adjusted 90-day mortality was 39.5% (95% CI, 33.1-45.9) with continuous infusion and 35.9% (95% CI, 32.4-39.4) with intermittent infusion (adjusted risk difference, 3.7%; 95% CI, -3.7 to 11.0; p = 0.33). No significant differences were observed for secondary outcomes.
CONCLUSIONS: Continuous infusion of high-dose meropenem was not associated with improved outcomes compared with intermittent infusion in critically ill patients.